Acute Perianal Abscess with Gluteal Panniculitis: A Case of Successful Surgical Management

ABSTRACT: Perianal abscesses are common surgical emergencies, yet atypical presentations can complicate diagnosis and management. We report the case of a 34-year-old male presenting with an acute perianal abscess associated with gluteal panniculitis. The patient complained of progressive pain, swelling, and erythema in the perianal and right gluteal region, without systemic symptoms. Imaging demonstrated subcutaneous panniculitis without deep extension or fistulous communication. The patient underwent incision and drainage with debridement of necrotic tissue, followed by intravenous antibiotics and daily wound care. Intraoperatively, a foreign body (fish bone) was retrieved from the abscess cavity, likely acting as the nidus of infection. Postoperative recovery was uneventful, with complete resolution of symptoms and no recurrence during follow-up. This case emphasizes the importance of combining clinical evaluation with imaging in atypical cases, as well as prompt surgical intervention to achieve favorable outcomes. Multidisciplinary vigilance is essential to prevent delayed diagnosis and complications.