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Ashling Ramdin, Christopher Smith, Max Marsden, Stephen Agboro, Michail Chatzikonstantinou, ThP6.5 - Anorectal Abscess and Diabetes Mellitus: An Overlooked Association?, British Journal of Surgery, Volume 111, Issue Supplement_8, September 2024, znae197.293, https://doi.org/10.1093/bjs/znae197.293
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Abstract
Patients with anorectal abscesses often require treatment from Emergency General Surgery. Prior European epidemiological studies report 6% of patients with anorectal abscesses have diabetes mellitus (DM). This study primarily quantified prevalence of DM, and secondarily, adherence to the WSES-AAST anorectal emergencies guidelines, which recommend routine HbA1c and serum glucose testing.
A retrospective analysis identified all surgically managed patients with anorectal abscesses at an urban DGH over a two-month period from 1st December 2023. Data were collected on demographics, existing DM status, HbA1c and blood glucose testing from the electronic health record.
The study included 17 patients, 59% male (10/17), with a mean age of 45 years (range 20-72). Among the group, 4/17 (24%) had a known DM diagnosis. Only 2/13 (15%) without a pre-existing DM diagnosis underwent DM testing. No new cases of DM were diagnosed. HbA1c and serum glucose testing were performed more commonly in patients with known DM compared to those without a prior diagnosis, but not significantly (3/4 vs 2/13, p=0.09).
The proportion of anorectal abscess patients with DM in our study is markedly higher than previously reported in the literature. Compliance with DM testing guidelines is poor, and the causes are uncertain. Routine DM screening for anorectal abscess patients could lead to earlier detection and improved outcomes. The actual incidence of newly detected DM in this patient group remains unknown due to inadequate testing, underscoring the need for further research to evaluate the real-world benefit and cost-effectiveness of following diabetes detection guidelines in these patients.