Anorectal Abscess with a Concomitant Simple Anal Fistula at Incision and Drainage

This protocol applies to patients presenting with anorectal abscess in whom a simple anal fistula is identified at the time of incision and drainage. The co-occurrence of these two conditions at the point of surgical intervention defines a distinct management situation that requires careful clinical judgement.

Management in this setting may involve a combined surgical approach addressing both the abscess and the fistula during the same operative encounter, in carefully selected patients. The decision to address the fistula at the time of abscess drainage is individualised and depends on patient-specific risk assessment.

The complete algorithm — including patient selection criteria, procedural details, and sequencing — is available in the full protocol.