Brief description of the disease
Paraproctitis - purulent inflammation of the rectum. The disease usually affects men between the ages 20-50let.
In addition, how the disease are acute and chronic paraproctitis, and depending on the localization of purulent inflammation (fistula) - subcutaneous, ishiorektalny, submucosal, pelviorektalny (pelvic, rectal) paraproctitis.
Paraproctitis: causes of
Causes paraproctitis infection that of the anal canal (from its crypts) penetrates the anal glands, where it develops. Pathogens may be Bacteroides, Clostridium, and other representatives of anaerobic flora (in this case paraproctitis runs hard, 15-40% are fatal) or staphylococcus, E. coli, streptococci (paraproctitis caused by these and other aerobic bacteria, in most cases successfully treated ).
Contribute to the development of the disease worsening immunity (documented cases of acute paraproctitis develop even after undergoing SARS), weight lifting, exercise, unhealthy diet consisting of fatty, spicy foods, excessive drinking, frequent diarrhea or constipation, hypothermia.
Women paraproctitis may occur due underwear, crashing into the crotch and injure the skin of the anus.
Primary acute paraproctitis developing fast, 3-5dn.
The first symptoms of subcutaneous abscess - redness of the skin around the anus, swelling, pain in the anus, defecation growing, constipation, fever. If the abscess is located closer to the front wall of the anus, painful urination may occur.
Ishiorektalny paraproctitis visually determined already in the later stages - in the form of anti-aliasing perianal folds gluteal obvious asymmetry. Therefore, the reason for medical examination should be a constant dull pain in the pelvis, rectum, which becomes stronger during defecation, general deterioration, fever. A more detailed examination in this type of abscess are thickening of the rectum and anal canal higher flattening folds of mucous on the affected side. At the end of the first week of the disease increases the local temperature, seal out into the lumen of the intestine, can hurt the urethra or prostate.
When submucosal abscess paraproctitis located closer to the lumen of the intestine, so the pus can escape. The patient feels pain in the gut that are strongly felt during defecation, had a moderately high body temperature.
Pelvic, rectal paraproctitis passes the most difficult and its symptoms as a dull pain deep in the pelvis and intestines, constipation and fever are already evident in the later stages, when there is an abscess (through 1-3ned). In the early stages of the disease can be detected during the inspection some soreness from the walls of the middle and upper parts of the rectum or seal. Pain patients in the early stages of the disease does not feel, but it is observed chills, weakness, loss of appetite.
Diagnosis of the disease
Diagnosis of subcutaneous abscess is quite simple - because of the severity of symptoms. Held in this case, only the toe inspection, and the finger introduced into the rectum and gently lead them along the wall opposite the one on which localized abscess. The diagnosis in this case is put on the basis of patient's symptoms, and the outer finger examination. Other research methods abscess, including tools do not apply because of increased soreness in the anus.
To determine ishiorektalnogo paraproctitis also often cost only finger inspection, in which the seal is usually detected at or above the anorectal line, and increased pain in the study of the nature of jerky from the crotch. Instrumental methods of diagnosis used in extreme cases.
Just explore and paraproctitis formed under the rectal mucosa.
An abscess that occurs when pelvic, rectal form of the disease, identify possible only with digital examination, but given the severity and depth of the inflammation, in some cases, using ultrasonography (US) or sigmoidoscopy (examination using a special device that is introduced into the anus).
Treatment abscess in most cases, surgery is indicated only.
Often, when an operation is carried out soon after paraproctitis examination of the patient and diagnosis - it is considered urgent.
Acute or chronic paraproctitis without treatment can cause scarring on the walls of the anal canal, and its deformation, failure of the anal sphincter.
Only in those cases where the purulent process is not found, the operation when paraproctitis lay prescribe a course of antibiotics, physiotherapy. But carrying out surgical abscess necessarily because not excluded relapse and various complications.
Also during the operation paraproctitis can be postponed if the disease is in remission and stable moves fistula closed because in this case it will be difficult to determine the lesion.
There are also times when the island was cured paraproctitis methods of conservative treatment: the patient is prescribed to do with potassium permanganate bath (water temperature 37-38grd) for 15-20min, to light candles with antibiotics, to impose on the anus to compress Vishnevsky ointment. But if drug treatment paraproctitis not yield any results, turn to radical surgery.
During the operation at paraproctitis necessarily reveal an abscess, clean it, are affected by the crypt, fistulous passages and cut them. For anesthesia procedures using general anesthesia. Local anesthesia is considered inappropriate.
After the abscess, cured by surgery, in case of an acute inflammatory process of the rehabilitation period 2-5ned. Moreover, after the abscess patient should be followed a diet prescribed by a doctor and a special hygiene: the wounds left after paraproctitis 2 p / day and after each bowel movement wash with warm soapy water.
Prevention of disease
To prevent the disease and after the abscess (relapse prevention) to avoid hypothermia, in time to undergo treatment of diseases of the rectum (anal fissures, hemorrhoids), follow the diet, avoid constipation and frequent disorders are periodically strengthen immunity, not to raise the back-breaking weight.