A 56-year-old non-insulin dependent diabetic presented with a three day history of a tender, enlarging right inner thigh mass just below the gluteal crease and near the perineum. There was no anal pathology or induration on rectal exam.
After a loading dose of broad spectrum antibiotic, the patient was taken to the operating room, spinal anesthesia was administered and he was placed in lithotomy position. There was a central fluctuant point so no localizing needle aspiration was performed. A #11 blade was used to make a stab wound into the center of the abscess and a sawing motion was used to enlarge the incision. About 25 cc of gray pus drained immediately.
Link to this frame from your Personal Thumbnails page?