Paraproctitis

Paraproctitis is a purulent inflammation of the peri-rectal tissue, requiring urgent surgical treatment. This is one of the most common proctological diseases that occur when infectious agents penetrate from the intestinal lumen or through the skin of the perineum (for example, during injury) into the perirectal tissue. The nature of the disease and its course depend on the type of infectious agents, their activity and the massiveness of penetration. The purulent focus can be located in various parts of the peri-rectal tissue, the clinical picture of the disease depends on this.

What happens with paraproctitis?

The onset, often acute, is observed after a short (up to 3 days) period of malaise, weakness, and headache. Chills and fever appear, pain in the rectum, perineum or pelvis increases, defecation is disrupted (constipation or diarrhea), and urination is often delayed. As the inflammatory process progresses, the general condition worsens: weakness and malaise increase, and body temperature rises to 39 °C.

In the area surrounding the anus, a painful inflammatory infiltrate (induration) appears, sometimes with skin hyperemia. The pain increases sharply with defecation, sitting, and physical activity.

Diagnosis of paraproctitis

During the period of general manifestations of the disease, patients are often treated by general practitioners for an acute respiratory infection, and only the increase in local symptoms forces them to consult a surgeon.

If you experience pain of any kind, discomfort in the rectum or perineum, you should immediately contact a surgeon.

Prevention of paraproctitis

Prevention of acute paraproctitis includes a number of measures: hygiene of the perineum and anus, stool regulation, treatment of proctological diseases (hemorrhoids, anal fissure, etc.). After defecation, it is necessary to wash the perineum and anal area with cool water.

Inflammation of the tissue surrounding the rectum, most often caused by the introduction of pyogenic microbes from the inflamed or damaged mucous membrane of the rectum. In acute paraproctitis, a limited accumulation of pus forms in the tissue - an abscess, and in more severe cases, suppuration takes on a diffuse character and phlegmon develops.

The severity of paraproctitis depends on the depth of the lesion. The least dangerous is subcutaneous paraproctitis - inflammation of the tissue surrounding the anus. With this superficial form, local signs of inflammation are clearly visible - painful swelling, redness of the skin near the anus, pain that sharply intensifies during bowel movements; the general condition of the patient suffers little.

In deep forms of paraproctitis, local signs of inflammation - compaction or purulent melting of tissues - can only be detected by a doctor during examination through the rectum; the pain may be dull and vague. But disturbances in the general condition of the patient are sharply manifested, which suffers the more, the deeper the focus of suppuration.

Sudden chills, a significant increase in temperature, rapid pulse, coated tongue, headaches, loss of appetite and other signs of a severe general illness usually serve as the first symptoms of deep, especially pelvic paraproctitis. If you contact a doctor late, sepsis may develop, threatening the patient’s life; in the best case, there is a breakthrough of pus into the lumen of the rectum, or through the skin of the perineum, or in both directions.

From the moment of breakthrough and outpouring of pus, paraproctitis takes a chronic course. Chronic paraproctitis is characterized by the presence of a persistently non-healing fistula leading from the purulent cavity to the skin or rectum, or connecting the intestinal lumen to the surface of the skin; in the latter case, not only pus, but also feces particles are released through the fistula.

Only with subcutaneous paraproctitis, a breakthrough of an abscess through the skin can sometimes lead to spontaneous recovery; in other cases, a surgeon is usually required to heal the fistula

Paraproctitis is a disease in which the inflammatory process spreads beyond the mucous membrane of the rectum to the adjacent tissue and fat spaces. This disease has its own characteristics.

Content:

Description of the disease. To determine the cause of the disease, it is necessary to understand what types of paraproctitis there are. The disease is divided into: - Acute. Develops within 4-6 weeks. Serous-purulent exudate appears as a result of the melting of fiber above the exit of the internal fistula opening. A tumor may appear in the anus. It reaches the size of a chicken egg, there is pus inside, the tissues become dense and red. Body temperature rises sharply. Chronic. It manifests itself in a period of exacerbation, during which there are no symptoms of acute paraproctitis in the system. Gradual resorption of the exudate leads to the formation of a scar. The disease occurs 3 times more often in men than in women. This is explained by the structural features of the anus. The cryptic region is located in the anus. Here the mucous membrane of the anal canal comes into contact with the fiber. It happens that the walls between them are narrower, so they are easily injured; for this reason, pathology in men more often develops in any form. Acute inflammation. No inflammation. With fatty secretions. The diagnosis is made on the basis of complaints and medical history. If pathology is detected, palpation of the anal area, anoscopy and sigmoidoscopy are indicated. Visual diagnostic methods include irrigoscopy. An effective way to determine the disease is ultrasound examination of the nodes located at the entrance to the anus. Conservative therapy. Surgery.