Paraproctitis
Paraproctitis means inflammation of the tissue around the rectum. It develops, When the passage of solid stools or strong straining occur tears mucosa, through which penetrates the infection.
More, However, germs are introduced into tissue through the rectum sinuses, located in its lower part. Hence, the infection spreads to the tissue and then formed ulcers. The latter can be positioned under the skin or mucosa. Deeper pockets are located in the tissue of the pelvis and the pelvic peritoneum, even under.
Acute paraproctitis in most cases it occurs in people of working age: 75% age of patients has 30 to 60 years. Men suffer in 3 times more likely, than women. Onset, usually, acute. It is expressed in the appearance of pain in the anus, which initially hampered sit, walk, then the intensity increases and they become permanent.
Very soon the temperature rises, appear chills, malaise, changes in blood. Sometimes she joins constipation, micturition. In some cases, come to the fore not in pain, and common symptoms of the disease - an increase in temperature, chills, weakness.
At this clinic, the patient must pay attention to the doctor even for minor pain or a feeling of fullness in the indefinite, inconvenience in the anus, foreign body sensation in the rectum. This will help the doctor suspect, and hence, timely and correct diagnosis.
Diagnosis paraproctitis
The deeper the ulcer is located in the pelvis, the more pronounced general symptoms of intoxication (poisoning), but the harder to identify and localize the site of infection. When viewed from the anus in some cases, we can immediately diagnose: swelling, Krasnoja, increase in skin temperature at one place around the anus indicate, the presence of an abscess. Other patients, especially when the focus is deep, it is not visible from the outside.
Occasionally acute paraproctitis may start gradually, with the appearance of small pains, low temperature. Such signs are held 3-4, and even 5 days, slow crescendo.
Treatment paraproctitis
With the rapid development of the disease, patients go to the doctor in early and receive effective assistance. However, in some cases even before the medical care ulcers erupt through the skin to the outside. This reduces the pain, temperature drop. As a result, the patient finds, he is recovering, He continues to treat yourself, I do not go to the doctor. This is a gross error.
This behavior of the patient may lead to the spread of purulent process and be sure to repeat the acute inflammation. Regardless of Togo, the abscess was discovered or not, the patient should consult a surgeon or a proctologist. Acute paraproctitis refers to those diseases, that the patient in any case should not try to treat. Applying heat or cold, and antibiotics, sometimes hurts, pushes only effective treatment, and in some cases promotes ulcer.
Thus, If you have pain in the anus, temperature increase, and in the presence of local signs, as the swelling, redness of the skin, increase in skin temperature, the patient is required to see a doctor. The only method of treatment of acute abscess - Surgical. For it is necessary to open the abscess. The operation is performed under general anesthesia. The length and location of the cuts depends on the location of the ulcers.
It should be noted some peculiarities of the course and treatment of acute abscess in children. In children, the disease is rare, in 40 times less, than in adults. Such causes of acute abscess, like diaper rash, scratching, injury, children are less frequent, than in adults.
Diagnosing acute paraproctitis children harder, than in adults, Since it is difficult to clarify, where is the source of pain, child's anxiety, temperature increase. In such cases, parents should carefully inspect all skin, including perineum. If there is an acute swelling of the abscess can be identified, redness, tension of the skin. These findings are reason for compulsory treatment to the doctor. Children, as well as in adults, treatment of acute paraproctitis should only be surgically.
Chronic paraproctitis
Chronic paraproctitis It is the next stage of acute abscess, it manifests itself in the form of rectal fistula: its formation can be attributed to the late or non-radical treatment of acute abscess. In 15% patients with acute paraproctitis subsequently remain rectal fistula. They may be internal (penetrate from the lumen of rectum tissue or other organs) and outer (opened on the skin). The latter are more common than the first.
When a portion of the outer skin fistulas around the external opening of the anus is usually the size of the hole fistula 1-3 millimeter, from which released a very small amount (1-2 Drops) pyo- or serous-purulent fluid. This fistula penetrated into the rectum, which has its inner bore.
Clinical manifestations of external fistula of the rectum small: minor aches, itch, namokanie, maceration of the skin. In the case of the closure of the external opening of the fistula and stopping pus pain intensifies, fever, in the anus appears swollen. In the presence of internal rectal fistula to the skin there are no holes, fistula opens into the lumen of the rectum. To recognize such a fistula is difficult.
The treatment of fistulas of the rectum is very difficult. Only surgery can help get rid of this suffering. There are many different operations, the essence of which is the most syringectomy. In some cases such a simple effective to intervene, how to cut the fistula wall.
We know from history, that the French King Louis XIV ("Sun King") He suffered from chronic paraproctitis rectum with fistula. Prolonged conservative treatment was unsuccessful. Then his court surgeon Felix produced a special curved knife pointed, end of which is introduced into the fistula and cut it. There was a recovery. The knife was named "Royal bistoury", and the operation became fashionable, and some flatterers of artificially made himself fistulas, then to undergo surgery.
It should be noted, that after surgery can sometimes occur relapse. It happens with complex branched fistula, which is not always possible to completely remove. Leaving even a small stroke of the fistula leads eventually to relapse.
