The chapter describes a case of a 28-year-old male with pain in the anal region, a history of Crohn’s disease, and a prior similar episode requiring surgery in the ED. The patient is examined, and it is found that he has an uncomplicated perianal abscess. The chapter details the primary and secondary surveys, history, action taken, results, diagnosis, critical actions, and pearls associated with perirectal abscesses. The critical actions include thorough examination, incision and drainage, and follow-up management. The chapter concludes by stating that antibiotics are not necessary unless the patient exhibits systemic involvement.

This chapter describes a case of a 42-year-old male with lower back pain, who is a current IV heroin user. The patient reports feeling generally weak, but denies focal weakness, incontinence, or sensory loss. The secondary survey reveals lumbar tenderness, diminished rectal tone, and a 3 cm abscess with surrounding erythema on the skin at the right inner thigh. The patient is diagnosed with spinal epidural abscess and is started on broad-spectrum IV antibiotics, undergoes incision and drainage of the abscess, and receives a spinal MRI. The chapter also highlights important pearls, including the fact that Staph aureusis the most commonly involved bacteria, and MRI imaging is the gold standard with a sensitivity and specificity greater than 90%.