Paraproctitis as a purulent inflammation of the tissues surrounding the rectum.

 

Paraproctitis as a purulent inflammation of the tissues surrounding the rectum.

(Alles Europa News) -Experts noted that the first and main task of diagnosing acute paraproctitis based on patient complaints, clinic and examination to recognize the presence and localization of the abscess in the cellular space surrounding the rectum.

Alles Europa News reports that the disease is detected during examination and a digital examination of the rectum.

To exclude complications of acute paraproctitis, women also need to consult a gynecologist, and men – at the urologist.

Alles Europa News noted that treatment of acute paraproctitis is only surgical.

The operation should be performed immediately after diagnosis. The operation is performed under general anesthesia.

Alles Europa News reports that since the purpose of the operation is to open an abscess (abscess) and remove pus.

After the operation, dressings are performed, antibiotics, vitamins , and immunity enhancers are prescribed .

Such an operation can be performed in any surgical hospital.

However, opening the abscess is not a radical operation: after it, as a rule, repeated suppuration occurs (chronic paraproctitis forms).

The reason for this phenomenon is the preservation of the inflammatory channel (fistula) between the rectum and surrounding tissues.

For a complete cure, a second operation is necessary, performed in a specialized proctological hospital.

As a result of such an operation, the connection between the intestinal cavity and the abscess is eliminated. It is called radical, because leads to a complete cure.

Complications.

Alles Europa News reports that with untimely surgical treatment of acute paraproctitis, complications may develop: purulent destruction of the rectum wall and / or urethra wall in men, pus breakthrough in the vagina in women.


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The most formidable complication is the breakthrough of pus into the pelvic cavity, which, with a late diagnosis, can lead to death.

After opening the abscess spontaneously or surgically without eliminating the purulent course and the affected crypt in the future, as a rule, a fistula of the rectum is formed.

If the fistula has not formed, but at the same time there remains a focus of inflammation in the region of the anal glands and intersphincter space, then after some time a relapse of acute paraproctitis occurs.

What are rectal abscesses (paraproctitis)?

There are acute (first occurring) and chronic paraproctitis (develops as a result of spontaneous or incorrect opening (treatment) of acute paraproctitis).

Alles Europa News reports that the Rectal abscesses are often found in patients with previous anorectal diseases, diabetes, alcoholism and neurological diseases; infections in this area most often also develop in patients with acute leukemia , especially in the presence of neutropenia.

Since the clinical picture can be regarded as a fever of unknown origin over a long period of time, it is important that patients with unexplained fever must have a thorough digital and endoscopic examination of the rectum.

Causes of rectal abscess (paraproctitis).

The causes of paraproctitis are many:

non-observance of personal hygiene rules,

traumatic manipulations in the anal canal,

the presence of diseases of the anus (hemorrhoids, anal fissures , cryptitis, etc.).

Through special glands located in the anus, infection from the lumen of the rectum enters the surrounding tissue. Inflammation develops, an abscess forms.

Therefore, a simple autopsy of abscesses from the outside, without reorganization of the internal inflamed area, does not lead to a permanent recovery.

Alles Europa News reports that Acute paraproctitis occurs with the rapid penetration of infection into the pararectal (peri rectal) cell space.

Depending on the human immunity, the size and location of the abscess can be different.

An abscess can be located directly below the perineal skin (subcutaneous – most often), and deep between the muscles of the perineum and buttocks (ischiorectal – sciatic-rectal, pelvic rectal pelvic-rectal, and as a type of pelvic-rectal posterior rectal (retrorectal).

Chronic paraproctitis often occurs with spontaneous or improper opening (treatment) of acute paraproctitis.

Acute paraproctitis.

Acute paraproctitis occurs with the rapid penetration of infection into the pararectal cell space subcutaneous (most often), ischiorectal, pelviorectal, retrorectal (very rare).

Depending on the affected space, paraproctitis is distinguished by localization of subcutaneous, etc.

The internal opening of the abscess is almost always one, the external abscesses can be two or more.

In more than half of patients, the abscess is located on the border of the mucosa and skin.

Symptoms of acute paraproctitis are primarily sharp pains that increase when walking, coughing , etc.

The general condition worsens, especially with deep (ischiorectal, pelvic-rectal) abscesses, while there are practically no external signs of redness of the skin, fluctuations.

With deep (high) ischiorectal and other acute paraproctitis, the patient’s condition may be severe high fever, signs of intoxication, pain in the depths of the pelvis.

Symptoms of acute paraproctitis.

The disease usually begins acutely. Following a short prodromal period with malaise, weakness, headache , growing pain in the rectum, perineum or pelvis appears, accompanied by fever and chills.

The severity of symptoms of acute paraproctitis depends on the localization of the inflammatory process, its prevalence, the nature of the pathogen, and the reactivity of the body.

With the localization of the abscess in the subcutaneous tissue, clinical manifestations are more pronounced and definite: painful infiltration in the anus, hyperemia of the skin, and an increase in body temperature usually make it necessary to consult a doctor in the first days after the onset of the disease.

A sciatica abscess in the early days of the disease is manifested by common symptoms: chilling, feeling unwell, dull pain in the pelvis and rectum, aggravated by bowel movements; local changes in the asymmetry of the buttocks, infiltration, hyperemia of the skin appear in the late stage (5-6th day).

The most difficult is pelviorectal paraproctitis, in which the abscess is located deep in the pelvis.

In the early days of the disease, the general symptoms of inflammation predominate: fever, chills, headache, pain in the joints, in the pelvis, in the lower abdomen.

Often the patient turns to the surgeon, urologist, women to the gynecologist. Often they are treated for acute respiratory illness, flu.

The duration of this period sometimes reaches 10-12 days. Further increase in pain in the pelvis and rectum, retention of stool, urine and severe intoxication are noted.

Chronic paraproctitis.

Chronic paraproctitis often occurs with spontaneous or improper opening (treatment) of acute paraproctitis.

The internal opening of the abscess in the anal canal does not heal and a fistula remains. Healing can occur with an unstable scar that ruptures with minor injury (cycling, constipation, etc.).

An abscess reappears, inflammation in the same place of the anal canal, while the localization of the abscess may be in another place of the perineum.

Alles Europa News reports that after improper opening and treatment, the wound on the perineum does not overgrow with the rectal fistula remains, while re-infection of the intestinal flora through the internal opening of the fistula occurs.

In most patients, the cause of the infection cannot be identified.

Rectal abscesses are usually very painful, easily detected by palpation, often visible upon examination. Treatment consists of an incision and drainage.

Alles Europa News note: Please always contact your doctor for best assistance and remember to never go on self medications.

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