Background: Anal gland obstruction causes 90% of peri-anal abscesses, with only 10% attributed to other causes. The incidence of peri-anal abscesses is unknown, due to single-institution publications and variation in the setting that treatment is performed. A history and physical exam are sufficient for diagnosis of peri-anal abscess. We seek to examine if a CT scan changes management in those who present to the emergency department as a single institution. 

Methods: This is a retrospective study with preliminary analysis of 20 random patients of a larger cohort diagnosed with a peri-anal abscess. Outcomes include length of stay, CT performed, time from patient presentation to when CT was performed, and if the CT scan was completed prior to surgical consult. A univariate analysis, and Student’s T-test, and chi-square test were performed using Social Sciences (SPSS) version 21.0 (SPSS Inc, Chicago, IL). Data reported as n (%) and median (IQR). 

Results: Chart review of 20 random patients demonstrated ten diagnosed in the ED and ten patients diagnosed during hospital admission. We found no statistically significant differences in age 43 years (30-50) vs 41 years (41-46), (p=0.94), gender with 90% being male (p=0.26), ethnicity include a majority of 70% Latino (p=0.17), CT scan being performed 16 of 20 (0.26), time elapsed from patient presentation to CT scan ordered include 12 hours (3-20), 2 hours (1-3), p=0.087, and if the CT scan was ordered before the surgical consult include a 9 out of 20 (0.653). 

Conclusion: CT scan prior to a surgical evaluation in the diagnosis of a peri-anal abscess is not a responsible practice. Cost, resources, and radiation exposure must be considered. Many patients who received CT imaging still required a surgical consult. More research determining the indication of a CT scan in the diagnosis of peri-anal abscess is warranted.