Diagnosing anorectal abscesses can be challenging in patients who present with non-specific symptoms or lack external signs such as redness and swelling. We present a case of a perirectal abscess where point-of-care ultrasound facilitated a rapid diagnosis.

A 56-year-old man presented to the ED with a 2-day history of intermittent lower back pain and urinary frequency. He was afebrile and there was no perineal erythema. A point-of-care abdominal ultrasound (POCUS) was obtained (figure 1, online supplemental video).

Transverse pelvic view of a point-of-care ultrasound.

What is the diagnosis?

Stool impaction

Diverticulitis

Perirectal abscess

Urinary retention

Anorectal abscesses are common infections in the anorectal region, …