Abstract Postoperative inadequate drainage of perianal abscess is prevalent in obese patients with diabetes, caused by obesity-related high tissue pressure and diabetes-induced impaired immunity/microcirculation. We report a 25-year-old obese male (BMI 37.9 kg/m2) with newly diagnosed type 2 diabetes who developed recurrent abscess on postoperative Day 3 after surgery for perianal abscess, anal fistula, and mixed hemorrhoids. He was treated with active catheter drainage, ceftriaxone-based targeted anti-infection (guided by Klebsiella pneumoniae culture), and metformin + liraglutide for glucose control. The patient fully recovered with normalized inflammatory markers and blood glucose, without recurrence or anal fistula formation at 1-year follow-up. This validates the efficacy of the comprehensive strategy for high-risk patients with long-term clinical outcomes.
Li et al. (Tue,) studied this question.