A case report of postoperative poor drainage of perianal abscess in an obese diabetic patient treated with comprehensive therapy

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.