Bezold abscess lies in relation to: March 2012
**Core Concept**
Bezold abscess is a type of pelvic abscess that occurs as a complication of pelvic inflammatory disease, particularly in cases of perforated appendicitis. It is characterized by the collection of pus in the buttocks or ischiorectal fossa, which is the fat-filled space between the skin and the anal canal.
**Why the Correct Answer is Right**
The formation of a Bezold abscess is due to the spread of infection from the pelvic cavity to the ischiorectal fossa through the fascial planes. This occurs when the infection perforates the pelvic fascia and spreads along the path of least resistance, ultimately accumulating in the ischiorectal fossa. The ischiorectal fossa provides a potential space for the abscess to form, which can then become a source of further infection and sepsis.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect as it does not accurately describe the location of a Bezold abscess. While the exact location can vary, it is typically found in the ischiorectal fossa, not in the suprapubic region.
* **Option B:** This option is incorrect as it does not accurately describe the mechanism of formation of a Bezold abscess. The abscess forms due to the spread of infection from the pelvic cavity, not through the lymphatic system.
**Clinical Pearl / High-Yield Fact**
A Bezold abscess is a classic example of a pelvic abscess that can occur as a complication of pelvic inflammatory disease. It is essential to consider this diagnosis in patients with signs of sepsis and a history of pelvic inflammatory disease or perforated appendicitis.
**Correct Answer: C. Ischiorectal fossa**