Benign perianal conditions commonly present on the acute general surgical take and in the outpatient setting. Accurate diagnosis and appropriate management is not only important in prevention of patient morbidity but also important in differentiation of these conditions from cancers. This article summarizes the presentation and current management of perianal abscess, fistula in ano, haemorrhoids, fissure and pilonidal sinus. Pseudo-obstruction, acquired megacolon and sigmoid volvulus constitute a group of benign lower gastrointestinal disorders that present as large bowel obstruction. In the Western society, these conditions commonly affect elderly patients with multiple comorbidities, who are often institutionalized therefore posing significant management challenges. Their clinical features, diagnosis and management will be covered in this article. Intra-abdominal abscesses are a common surgical problem, occurring primarily in association with a variety of perforating or suppurative intra-abdominal visceral diseases or secondary to postoperative complications, including anastomotic dehiscence. Early diagnosis and recognition of associated pathology, based on clinical assessment and appropriate investigation, including accurate cross-sectional imaging and interpretation, are essential for the planning of treatment and eradication of sepsis. Safe image-guided percutaneous drainage and administration of appropriate antibiotics is the gold standard, with surgical intervention mostly required for delayed definitive treatment after resolution of sepsis, after failed conservative treatment or in the emergency setting for an acutely unwell patient. Specific considerations for the diagnosis and management of the more commonly-encountered pelvic and intra-abdominal abscesses, particularly diverticular abscesses, are further discussed in this article.

With Regards,
Sara Giselle
Associate Managing Editor
Global  Journal of Digestive Diseases