Perianal abscess mimicking levator ani syndrome: a case report and approach to the differential diagnosis of anorectal pain.

OBJECTIVE: To present the clinical management and comprehensive differential diagnosis of a patient with anorectal pain from a perianal abscess.

CLINICAL FEATURES: A 41-year-old woman presented with pain localized to her perianal and gluteal region, accompanied by internal and external rectal pain. Prior to presentation, the patient had received a working diagnosis of levator ani syndrome.

INTERVENTION AND OUTCOME: An interdisciplinary management approach was utilized. Diagnostic imaging confirmed the clinical suspicion of a perianal abscess and the patient underwent surgical drainage.

SUMMARY: Anorectal pain is complex and multifactorial and a diagnosis such as an abscess should not be overlooked. This case emphasized that practitioners must be diligent in their evaluation and management of patients with anorectal pain, including recognizing situations that require further imaging and interdisciplinary management.