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December 25, 2016 00:09

paraproctitis

Paraproctitis - inflamed tissue (adrectal) surrounding the rectum.Of the total number Proctologic diseases abscess accounts for 15.1%.Paraproctitis usually develops in the anal crypts.Symptoms of abscess - pain and swelling.The diagnosis is established during the inspection, and CT or MRI of the pelvis with a deep abscess.paraproctitis Treatment consists of surgical drainage.

anorectal abscess - collection of pus in a limited adrectal area.

What causes abscess?

believed that men suffer paraproctitis more often than women.Considering the messages of various authors, this ratio ranges from 1.5: 1 to 4.7: 1.Although paraproctitis regarded mainly as a disease of adults, it is found in children.In one series of observations described 200 cases of abscess in children aged from newborn up to 14 years.

are 3 fascial-cellular spaces: subcutaneous, ishiorektalnoe-rectal and pelvic.Accordingly, the paraproctitis divided into subcutaneous, submucosal, ishio-rectal and pelvic-rectal.Paraprosktit caused by v

arious pathogens penetrating into the cellular spaces of the rectum through the anal glands, mucosal damage, as well as hematogenous or lymphogenous way to neighboring organs affected by the inflammatory process.

particular importance in the pathogenesis of abscess has a direct damage to the rectal mucosa in the anal canal posterior wall, which has a wide and deep crypt, is the gateway of infection.Each crypt is opened from 6 to 8 ducts of the anal glands.According to him the infection spreads in adrectal cellular spaces.The majority of patients (98%) and non-specific abscess caused by staphylococcus in combination with E. coli.Specific infections (tuberculosis, actinomycosis, syphilis) occurs in 1-2% of patients paraproctitis.

Paraproctitis can be localized in different areas surrounding the rectum, and is superficial (subcutaneous) or deep.Perianal abscess located beneath the skin surface.Ishiorektalny deeper abscess extends from ishiorektalnoe sphincter in the space below the erector muscle of the anus;abscess may extend to the opposite side, forming an abscess in a "horseshoe".Abscess above the muscle that raises the anus (.. Ie nadmyshechny abscess pelviorektalny abscess), located deep enough and can reach the peritoneum, or abdominal cavity;This abscess is often the result of diverticulitis or inflammatory pelvic disease.Sometimes anorectal abscess is a manifestation of Crohn's disease (especially the colon).Usually there is a mixed infection, including Escherichia coli, Proteus vulgaris, Bacteroides, Streptococcus aureus with predominance.

Symptoms paraproctitis

superficial abscesses can occur with severe pain;characterized by swelling in the perianal area, redness and pain.Deeper abscesses may be less painful, but cause symptoms of intoxication (eg., Fever, chills, malaise).When viewed from the local symptoms abscess sometimes absent, but on digital rectal examination may reveal tenderness of the intestinal wall and fluctuating diverticulum wall.High pelviorektalnye abscesses may cause pain in the lower abdomen and a fever without signs from the rectum.Sometimes fever is the only symptom of the disease.

Treatment paraproctitis

can not expect spontaneous breakthrough ulcer is urgently needed opening and adequate drainage of the abscess.Superficial abscesses may be drained on an outpatient basis;deeper abscesses require drainage in the operating room.Patients with diabetes or fever need antibiotics (eg, ciprofloxacin 500 mg / in every 12 hours and 500 mg of metronidazole in / in every 8 hours ampicillin / sulbactam 1.5 g / in every 8 hours.);patients with subcutaneous abscesses antibiotics are required.After draining can be formed anorectal fistula.