All Perianal Abscesses are Not Necessarily Cryptoglandular in Origin – Beware!

Perianal abscess is the most common abscess that arises from the anal glands in the crypts of the dentate line of anal canal mucosa. Over 90% of perianal abscess originates at the level of the dentate line where the squamocolumnar junction and 4-10 anal glands reside. Anorectal abscess due to non-cryptoglandular etiology is uncommon. We present a perianal ischiorectal abscess secondary to a ruptured prostatic abscess in a diabetic patient. Urinary tract infection in diabetes leads to prostatic abscess formation especially patients with voiding disturbances. Anorectal abscesses should be adequately assessed with symptoms, physical examination, laboratory, and imaging, and rarely underlying causes of inflammation of adjacent organs, such as the prostatic abscess, should be kept in mind. It is a rare clinical condition, only a few cases reported in the literature.