{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:22:28Z","timestamp":1768436548804,"version":"3.49.0"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,5,10]],"date-time":"2019-05-10T00:00:00Z","timestamp":1557446400000},"content-version":"vor","delay-in-days":129,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,1]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Supralevator abscess is the least common type of anorectal abscess. Its diagnosis can be hard and treatment difficult.<\/jats:p>\n <\/jats:sec>\n \n Presentation of the case<\/jats:title>\n A 48-year-old men was diagnosed in the emergency department with a supralevantor abscess. Under general anaesthesia, the abscess drainage was accomplished after removal of a fish bone, who was perforating the rectum. Due to persistent rectal purulent discharge, a pelvic Magnetic Resonance (MRI) was performed: a supralevator abscess adjacent to the internal obturator muscle and an inter-sphincteric fistulae from the inferior margin of this collection were identified. A Pezzer\u00ae drain was placed through the fistula tract. After radiological resolution, under general anaesthesia, the patient was submitted to extraction of the drain and marsupialization of the path left using an ENDO GIA\u00ae. At two year follow up he remained asymptomatic.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Despite of the abscess aetiology, the principles of treatment are the same: good radiological characterization and proper drainage. An adequate radiological characterization is important to avoid iatrogenic creation of a complex fistulae.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n If a supralevator abscess diagnosis is made, fistulae trajectory should be studied. If no clear internal opening is evident, a pelvic MRI should be done followed by drainage of the abscess. After resolution the drain should be taken off and marsupialization with ENDO GIA\u00ae should be performed.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n <\/jats:sec>","DOI":"10.1016\/j.ijscr.2019.05.016","type":"journal-article","created":{"date-parts":[[2019,5,13]],"date-time":"2019-05-13T11:03:25Z","timestamp":1557745405000},"page":"128-131","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Supralevator abscess"],"prefix":"10.1097","volume":"59","author":[{"given":"David Jo\u00e3o","family":"Apar\u00edcio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Leichsenring","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cisaltina","family":"Sobrinho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuno","family":"Pignatelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasco","family":"Geraldes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00edtor","family":"Nunes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-32-20260114","first-page":"5","article-title":"A retrospective analysis of 93 cases with anorectal abscess in a rural state hospital","volume":"31","author":"Akkapulu","year":"2015","journal-title":"Ulusal. 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