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The patient was ultimately treated with incision and drainage with Penrose drain placement. This case demonstrates the importance of maintaining a high suspicion for horseshoe abscess, a complex form of ischiorectal fossa abscess which can be missed on CT and US imaging, and which may expand rapidly in immunosuppressed patients.<\/jats:p>","DOI":"10.1136\/bcr-2024-261266","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T22:41:02Z","timestamp":1722379262000},"page":"e261266","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Delayed diagnosis of perirectal horseshoe abscess and patient\u2019s perspective"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0799-965X","authenticated-orcid":false,"given":"Afeefah Fatimah","family":"Khazi-Syed","sequence":"first","affiliation":[{"name":"Medical School, The University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Hoffer","sequence":"additional","affiliation":[{"name":"Medical School, The University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Imphean","sequence":"additional","affiliation":[{"name":"Radiology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9242-633X","authenticated-orcid":false,"given":"Lanna","family":"Felde","sequence":"additional","affiliation":[{"name":"Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"2025082700035780000_17.7.e261266.1","unstructured":"Turner SV , Singh J . 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