Post-Abscess Hard Lump Near Anus: Should You Worry?

After the abscess near the anus has been drained, it has turned into a painless, firm lump upon palpation?

Hello, doctor.
Around mid-November, I developed an abscess near my anus (toward the coccyx) that was about the size of a ten-dollar coin.
It was extremely painful even when walking.
After taking a second-line antibiotic for two weeks, the swelling completely subsided (without any rupture during that time), but a small hard lump remains at the same site, which is not painful when pressed.
However, this lump has persisted for another ten days.
Will it be absorbed by the body on its own, or is there a need for surgical removal?

Mr. Wang, 30~39 year old female. Ask Date: 2022/12/17

Dr. Zhang Shuhao reply Surgery

If there are no symptoms, it may not be necessary to take immediate action; instead, observe whether the swelling and pain recur.
A simple subcutaneous abscess may resolve on its own after the inflammation and infection are controlled.
However, if the source of the abscess is from the anal glands, which are connected to the rectum, it is referred to as an anal fistula, and the swelling and pain are likely to recur easily.
Once an anal fistula develops, surgical removal is recommended.

Reply Date: 2022/12/17

More Info

When it comes to a post-abscess hard lump near the anus, there are several factors to consider regarding its nature, potential risks, and the need for further intervention. Based on your description, it seems that you experienced an abscess that was treated with antibiotics, leading to a reduction in swelling but leaving behind a hard lump.

Understanding the Hard Lump
1. Nature of the Lump: After an abscess resolves, it is not uncommon for a hard lump to remain at the site. This lump could be a residual area of inflammation, scar tissue, or a small cyst that formed as a result of the abscess. In many cases, these lumps can be absorbed by the body over time, especially if they are not painful and do not show signs of infection.

2. Abscess Healing Process: The body often forms scar tissue as part of the healing process after an abscess. This scar tissue can feel firm or hard to the touch. If the lump is not painful, does not change in size, and there are no other symptoms (such as fever, increased pain, or drainage), it may simply be a benign remnant of the healing process.

When to Worry
1. Signs of Infection: If you notice any signs of infection, such as increased redness, warmth, swelling, or discharge from the lump, you should seek medical attention. These could indicate that the abscess has not fully resolved or that a new infection has developed.

2. Persistent Symptoms: If the lump persists for an extended period (typically more than a few weeks) without signs of improvement, or if you develop new symptoms, it may warrant further evaluation.
3. Pain or Discomfort: While you mentioned that the lump is not painful upon pressure, any new or worsening pain should be assessed by a healthcare professional.

Surgical Intervention
1. Indications for Surgery: Surgical intervention may be necessary if the lump does not resolve on its own, especially if it is suspected to be a residual abscess or if it causes discomfort. A healthcare provider may recommend an incision and drainage procedure if there is concern about the lump being an abscess that has not fully healed.

2. Consultation with a Specialist: It is advisable to consult with a colorectal surgeon or a healthcare provider specializing in this area. They can perform a physical examination and may recommend imaging studies (like an ultrasound) to better understand the nature of the lump.

3. Monitoring: If the lump is stable and asymptomatic, your doctor may suggest a watchful waiting approach, monitoring it over time to see if it resolves on its own.

Conclusion
In summary, while a hard lump following an abscess can be a normal part of the healing process, it is essential to monitor it for any changes. If you experience any new symptoms or if the lump persists without improvement, it is crucial to seek medical advice. A healthcare professional can provide a thorough evaluation and determine whether surgical intervention is necessary or if conservative management is appropriate. Always prioritize your health and do not hesitate to reach out for medical guidance when in doubt.

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