Paraproctitis

Short characteristic of a disease

Paraproctitis – a purulent inflammation of a rectum. A disease men aged usually have 20-50lt.

How there passes the disease, distinguish an acute paraproctitis and chronic, and depending on the place of localization of a purulent inflammation (fistula) - a hypodermic, ishiorektalny, submucosal, pelviorektalny (tazovo-pryamokishechny) paraproctitis.

Paraproctitis: emergence reasons

Causes a paraproctitis an infection which from the proctal canal (from its kript) gets into proctal glands where develops. Bacteroids, clostridiums, other representatives of anaerobic flora can be activators (in this case the paraproctitis proceeds hard, in 15-40% comes to an end with a lethal outcome) or staphylococcus, colibacillus, streptococci (the paraproctitis caused by these and other aerobic bacteria in most cases is successfully treated).

Development of a disease is promoted by deterioration in immunity (cases when the acute paraproctitis developed even after the postponed SARS are recorded), a raising of weights, exercise stresses, the improper feeding consisting of greasy, spicy food, excessive alcohol intake, frequent diarrheas or locks, overcooling.

At women the paraproctitis can arise because of the underwear crashing into a crotch and injuring anus skin.

Disease symptoms

Primary acute paraproctitis develops quickly, for 3-5dn.

The first symptoms of a hypodermic paraproctitis – erubescence around an anus, hypostasis, pain in an anus, at defecation amplifying, a chair delay, the increased body temperature. If the abscess is located closer to a front wall of an anus, the urodynia can be observed.

The Ishiorektalny paraproctitis visually is defined already at late stages – in the form of smoothing of perianal folds, explicit buttock asymmetry. Therefore constant dull ache in a basin, a rectum which at defecation becomes stronger the general aggravation of symptoms, a fever has to become a reason for medical examination. At more detailed survey at this type of a paraproctitis find a thickening of a rectum higher than the proctal channel and a smoothness of folds mucous on the struck party. At the end of the first week of a disease temperature increases locally, consolidation comes out in a gut gleam, can touch an urethra or a prostate gland.

At a submucosal paraproctitis the abscess is located closer to a gut gleam therefore pus can come to light. The patient feels pains in a gut which stronger are felt at defecation, he has moderately high temperature of a body.

The Tazovo-pryamokishechny paraproctitis passes most hard and its symptoms in the form of dull aches deeply in a basin and a gut, delays of a chair and fever are shown already at its late stages when the abscess appears (through 1-3ned). At an early stage of a disease at survey it is possible to find morbidity of a rectum, some of walls of average and upper departments, or consolidation. The patient of pain at an early stage of a disease does not feel, but it observes a fever, weakness, appetite loss.

Diagnosis of a disease

Diagnosis of a hypodermic paraproctitis is quite simple – because of the expressed disease symptoms. Inspection is performed in this case only manual, and the finger into a rectum is entered carefully and conducted them on the wall opposite to that on which the abscess was localized. The diagnosis is made in this case on the basis of complaints of the patient, external and manual examination. Other methods of a research of a paraproctitis, including tool are not applied in view of the increased morbidity in the field of an anus.

For definition of an ishiorektalny paraproctitis often also manage only manual survey at which consolidation at the level or above the anorectal line and strengthening of pain usually is found at a research of tolchkoobrazny character from a crotch. Tool methods of diagnosing apply in extreme cases.

Also investigate also the paraproctitis formed under mucous a rectum.

The abscess arising at a tazo-pryamokishechny form of a disease can be distinguished only at a manual research, but considering weight and depth of an arrangement of an inflammation, in certain cases use an ultrasonografiya (ultrasonography) or a rektoromanoskopiya (inspection by means of the special device which is entered into an anus).

Treatment of a paraproctitis

Treatment of a paraproctitis is in most cases shown only surgical.

Often operation at a paraproctitis is performed soon after survey of the patient and diagnosis – it is considered urgent.

The acute or chronic paraproctitis without treatment can lead to emergence of hems on walls of the proctal channel and its deformation, insufficiency of a proctal sphincter.

Only when purulent process is not found, operation at a paraproctitis is postponed, appoint a course of antibiotics, physiotherapeutic procedures. But performing surgical treatment of a paraproctitis is obligatory since the recurrence and various complications are not excluded.

Also operation at a paraproctitis can be postponed if the disease is in steady remission and the courses of fistula are closed since in this case it will be difficult to define area of defeat.

There are also cases when the acute paraproctitis was cured by methods of conservative treatment: to the patient appoint to do trays with potassium permanganate (water temperatures 37-38grd) on an extent 15-20min, to put candles with antibiotics, to impose on an anus a compress with Vishnevsky's ointment. But if drug treatment of a paraproctitis did not bring result, address radical operation.

During operation at a paraproctitis surely open an abscess, clean it, find the struck crypts, the fistular courses and cut out them. For anesthesia of the procedure use the general anesthesia. Local anesthesia is considered inexpedient.

After the paraproctitis cured in the surgical way in case of acute inflammatory process the term of rehabilitation makes 2-5ned. Besides after a paraproctitis the patient should keep to the diet appointed by the doctor and special hygiene: the wounds which remained after a paraproctitis 2 р / day and after each defecation are washed with warm soap water.

Prevention of a disease

For the prevention of a disease and after a paraproctitis (for prevention of a recurrence) it is necessary to avoid overcoolings, in time to undergo therapy of diseases of a rectum (proctal cracks, hemorrhoids), to watch food, not to allow frequent locks and frustration, to strengthen periodically the immunity, not to lift excessive weights.