Lump near anus one year after reconnecting ileum

[dietitian4242]

Yesterday my husband, aged 54yrs had drainage of an abscess? diagnosed following ct scan for a lump between anus and scotum which tripled in size over the previous week. Has been in pain since the May 08 followup colonoscopy which led to bleeding for 2 days, and then a month of ++ bleeding in September. Severe pain - on Tramal twice per day plus paracetamol 4 x day. It is one year since his reconnection of ileum after low anterior resection in August 07 for stage 2, no nodes rectal cancer - he had 6 weeks of pre-op chemo and radiotherapy which resulted in complete pathologic response (on post-op tissue pathology).  My question is - the lump is still there, same size. Was it really an abscess and should be lump be smaller after drainage? Many thanks

[jbutt]

Had stage 3T, if I remember correctly, rectal cancer diagnosed in Feb. 2005, female, 48 years old at time.  Radiation before surgery.  Never certain if I had node involvement, but tumor was through the wall.  Rectum removed and "j-loop" surgically "installed".  I have had continuously before and after surgery IBS and much diahrea and now have stool incontinence.  Surgeon just drained what he called a subcutaneous staph infection (very painful) next to anus.  I am concerned that it could be sign of cancer returning.  What should I do next?  Also have been diagnosed with bacterial overgrowth and took lots of expensive antibiotics about 2 years ago.  The IBS et al is annoying, but I am scared of cancer return.  Could there be any connection between the abcess/infection and any prior problems?  I have had one colonoscopy that did not show cancer two years ago.

[PaulMD]

Hi.

What he has may really be a peri-anal abscess which has a sinus draining connection in one of the anal crypts inside the anal canal.  This is really very hard to treat with medical management alone (such as antibiotics) and may need repeated surgeries and drainage.  The tract of the abscess should also be unroofed but this may have a complication of fecal incontinence and should be best handled by a very experienced surgeon.  Peri-anal abscesses can indeed be seen in patients who had a course of radiation to the area before.

I suggest you inform his surgeon about these developments.

Regards and God bless.