Ischiorectal abscess causes. Ischiorectal Abscess: Causes, Symptoms, and Treatment Options
What are the main causes of ischiorectal abscesses. How can you identify the symptoms of an ischiorectal abscess. What treatment options are available for ischiorectal abscesses. How can ischiorectal abscesses be prevented.
Understanding Ischiorectal Abscesses: A Comprehensive Guide
An ischiorectal abscess, also known as a perianal or rectal abscess, is a painful condition that occurs when a cavity in the anus becomes filled with pus. This medical issue can cause significant discomfort and potential complications if left untreated. In this comprehensive guide, we’ll explore the causes, symptoms, and treatment options for ischiorectal abscesses, providing you with the information you need to understand and manage this condition effectively.
The Anatomy of an Ischiorectal Abscess
To better understand ischiorectal abscesses, it’s essential to have a basic grasp of the anatomy involved. The ischiorectal fossa is a space located on either side of the anal canal, filled with fat and connective tissue. When an infection occurs in this area, it can lead to the formation of an abscess.
Are ischiorectal abscesses common. While not as prevalent as some other anal conditions, ischiorectal abscesses are not uncommon, particularly in certain high-risk groups. They are twice as likely to occur in males compared to females, and certain medical conditions can increase the risk of developing these abscesses.
Causes and Risk Factors of Ischiorectal Abscesses
Understanding the causes and risk factors associated with ischiorectal abscesses is crucial for prevention and early intervention. Several factors can contribute to the development of these painful conditions:
- Anal gland blockage or infection
- Tears in the anal tissue (anal fissures)
- Sexually transmitted infections (STIs)
- Inflammatory bowel diseases (e.g., Crohn’s disease, ulcerative colitis)
- Compromised immune system
- Diabetes
- Anal sex
- Use of certain medications (e.g., prednisone, immunosuppressants)
- Recent chemotherapy
- Chronic constipation or diarrhea
- Smoking
Can a history of anal fissures increase the risk of ischiorectal abscesses. Yes, individuals with a history of anal fissures, particularly children who have experienced constipation-related tears, are at a higher risk of developing ischiorectal abscesses later in life.
Recognizing the Symptoms of Ischiorectal Abscesses
Identifying the symptoms of an ischiorectal abscess is crucial for seeking timely medical attention. The most common signs and symptoms include:
- Constant, throbbing pain in the anal area
- Swelling and tenderness around the anus
- Increased pain during bowel movements
- Constipation
- Rectal discharge or bleeding
- Fatigue
- Fever and chills
- Difficulty urinating
In some cases, a visible or palpable lump may be present at the rim of the anus. This nodule is typically red, swollen, and tender to the touch. For deeper abscesses, particularly in individuals with inflammatory bowel diseases, pain or discomfort may be felt in the abdominal area.
Ischiorectal Abscesses in Children
Do ischiorectal abscesses present differently in children. In toddlers and young children, the symptoms of ischiorectal abscesses may be less pronounced. The primary signs to watch for include:
- General discomfort or pain, leading to irritability
- A visible or palpable lump around the anal area
Parents should be vigilant and consult a pediatrician if they suspect their child may have an ischiorectal abscess, especially if the child has a history of constipation or anal fissures.
Diagnosing Ischiorectal Abscesses: From Physical Exams to Imaging
Accurate diagnosis of ischiorectal abscesses is essential for appropriate treatment. The diagnostic process typically involves the following steps:
Physical Examination
The primary method of diagnosing ischiorectal abscesses is through a physical examination. A healthcare provider will check the anal area for characteristic nodules, pain, redness, and swelling. They will also rule out other conditions that may present similar symptoms.
Anoscopy
In cases where there are no visible signs of an abscess on the skin surface, a doctor may use an instrument called an anoscope to examine the anal canal and lower rectum.
Imaging Studies
For deeper abscesses that cannot be detected through physical examination alone, imaging tests may be necessary. These can include:
- CT scan
- MRI
- Ultrasound
These imaging techniques provide a more detailed view of the affected area, helping to determine the size and location of the abscess.
Additional Testing
In some cases, particularly when Crohn’s disease is suspected as a contributing factor, additional tests may be required. These can include:
- Blood tests
- Stool tests
- Colonoscopy
A colonoscopy is an outpatient procedure that allows a doctor to examine the colon and large intestine using a flexible scope with a light.
Treatment Options for Ischiorectal Abscesses
Ischiorectal abscesses rarely resolve on their own and typically require medical intervention. The primary treatment options include:
Drainage
The most common and straightforward treatment for ischiorectal abscesses is drainage of the pus from the infected area. This procedure can often be performed in a doctor’s office under local anesthesia. The doctor will make a small incision to allow the pus to drain, providing immediate relief from pressure and pain.
Surgical Intervention
For larger or more complex abscesses, surgical treatment under general anesthesia may be necessary. In some cases, a catheter may be inserted to ensure complete drainage of the abscess.
Is stitching required after draining an ischiorectal abscess. Typically, abscesses that have been drained are left open and do not require stitches. This allows for continued drainage and proper healing of the affected area.
Antibiotics
While not always necessary, antibiotics may be prescribed in certain situations, such as:
- Patients with diabetes
- Individuals with weakened immune systems
- Cases where the infection has spread beyond the abscess
Your healthcare provider will determine if antibiotics are necessary based on your individual case and medical history.
Potential Complications of Untreated Ischiorectal Abscesses
Leaving an ischiorectal abscess untreated can lead to severe complications. These may include:
Anal Fistulas
An anal fistula is an abnormal opening that develops between the anal canal and the skin near the anus. This complication can occur when an abscess breaks open on the skin surface.
Sepsis
In rare cases, untreated abscesses can lead to sepsis, a life-threatening condition caused by the body’s extreme response to infection.
Fournier’s Gangrene
This rare but potentially life-threatening infection can develop as a complication of untreated ischiorectal abscesses.
Given these potential complications, it’s crucial to seek medical attention if you suspect you have an ischiorectal abscess.
Prevention and Long-Term Management of Ischiorectal Abscesses
While not all cases of ischiorectal abscesses can be prevented, there are steps you can take to reduce your risk and manage your long-term health:
- Maintain good anal hygiene
- Treat underlying conditions such as inflammatory bowel diseases or diabetes
- Practice safe sex and use protection during anal intercourse
- Manage chronic constipation or diarrhea
- Quit smoking
- Maintain a healthy diet and exercise routine to support overall immune function
Can ischiorectal abscesses recur. Yes, there is a risk of recurrence, particularly if the underlying cause is not addressed. Follow-up care with your healthcare provider is essential to monitor for potential recurrence and manage any contributing factors.
When to Seek Medical Attention for Suspected Ischiorectal Abscesses
It’s important to consult a healthcare professional if you experience any of the following symptoms:
- Persistent anal pain, especially if accompanied by swelling or redness
- Fever or chills
- Rectal bleeding or discharge
- Difficulty with bowel movements or urination
Early intervention can prevent complications and lead to more effective treatment outcomes.
Ischiorectal abscesses, while painful and potentially serious, are treatable conditions. By understanding the causes, recognizing the symptoms, and seeking prompt medical attention, you can effectively manage this condition and reduce the risk of complications. Remember that proper diagnosis and treatment by a healthcare professional are essential for optimal outcomes and long-term anal health.
Perianal (Anal) Abscess: Causes, Symptoms, and More
An anal abscess, also known as a perianal or rectal abscess, occurs when a cavity in the anus becomes filled with pus. Symptoms may include pain, constipation, or fever. Treatment may include drainage of the abscess or surgery.
A perianal abscess occurs when a cavity in the anus becomes filled with pus. The terms “anal abscess” and “rectal abscess” can also be used to describe this same condition.
Anal abscesses can cause:
- extreme pain
- fatigue
- rectal discharge
- fever
In some cases, they can result in painful anal fistulas. This occurs when the abscess breaks open on the surface of the skin. If an anal abscess isn’t drained, it can cause a lot of pain and may require surgery.
A rectal abscess can happen when a tear in that area becomes infected or an anal gland becomes blocked. A sexually transmitted infection (STI) can also cause anal abscesses.
Toddlers or children that have a history of anal fissures (tears in the anal sphincter) are also at a higher risk for developing anal abscesses later on.
Such anal fissures might occur in children who have a history of constipation.
Anal abscesses are twice as likely in males compared with females.
Some other risk factors include:
- Crohn’s disease or ulcerative colitis, which are inflammatory bowel diseases that cause the body to attack healthy tissue
- diabetes
- a compromised immune system due to conditions like HIV or AIDS
- anal sex, which can increase the risk of anal abscesses
- use of the medication prednisone or other steroids
- current or recent chemotherapy or use of immunosuppressant medications
- constipation
- diarrhea
- smoking
This condition is likely underdiagnosed, as many people may not seek medical attention because they believe they may be experiencing hemorrhoids. It’s important to make an appointment with a doctor if you believe you have a perianal abscess.
If left untreated, anal abscesses can lead to severe complications, such as:
- an anal fistula, an atypical opening in the skin near the anus
- sepsis, a life threatening condition due to your body’s response to an infection
- Fournier’s gangrene, a rare but potentially life threatening infection
Throbbing and constant pain in the anal area can be one of the most common and immediately noticeable symptoms of an anal abscess.
The pain is usually accompanied by swelling in the anal area and greater pain during bowel movements.
Common signs of an anal abscess include:
- constant pain that can be dull, sharp, throbbing, or aching
- constipation
- rectal discharge or bleeding
- swelling or tenderness of the skin surrounding the anus
- fatigue
- fever
- chills
Some people may be able to feel a nodule or lump that’s red, swollen, and tender at the rim of the anus. Fever and chills can result from the infection. You may also have rectal bleeding or urinary symptoms, such as difficulty urinating.
Anal abscesses may also occur deeper in the rectum, most often in those who have inflammatory bowel diseases. This can result in some pain or discomfort in the abdominal area.
In toddlers, there typically aren’t many symptoms other than signs of discomfort or pain, which may cause a child to become irritable. A lump or nodule may also be visible or felt around the anal area.
Anal abscesses are most often diagnosed through a physical exam where a doctor checks the area for characteristic nodules. The doctor may also check for pain, redness, and swelling in the anal area and rule out other conditions.
In some people, there may not be any visible signs of the abscess on the surface of the skin around their anus. The doctor will instead use an instrument called an anoscope to look inside the anal canal and lower rectum.
Sometimes, the abscess may be deeper than a physical exam can find. The doctor may order imaging tests, such as a CT scan, MRI, or ultrasound, to get a better look.
Further tests may be necessary to make sure Crohn’s disease isn’t a contributing factor.
In these cases, blood and stool tests, imaging, and a colonoscopy may be needed. A colonoscopy is an outpatient procedure in which a doctor uses a flexible scope with a light to examine the colon and large intestine.
Anal abscesses rarely go away without treatment from a doctor.
Treatment may include drainage or surgery.
The most common and simple treatment is for a doctor to drain the pus from the infected area.
This can usually be done in the doctor’s office. The doctor will use medication to numb the area. Any uncomfortable pressure should be relieved, allowing the tissue to begin healing properly.
If there’s an extremely large anal abscess, surgery with anesthesia may be required. In some cases, a catheter may be used to make sure the abscess drains completely. Abscesses that have been drained are typically left open and don’t require stitches.
If you have diabetes or a weakened immune system, your doctor may ask you to stay in the hospital for a few days to watch for any infection.
Treatment following drainage may include:
- Medication. The doctor may prescribe antibiotics if you have a weakened immune system or if the infection has spread. Antibiotics are not considered sufficient to treat the infection on their own but may be prescribed after draining the abscess.
- Laxatives or fiber supplements. As you heal after draining the abscess, your doctor may recommend laxatives or fiber supplements to avoid constipation.
- Warm baths. After this procedure, the doctor may provide guidance on how to keep the area clean and may recommend a sitz bath. It’s recommended you take warm (not hot) baths. Sitting in warm water may help reduce swelling.
- Follow-up appointments. Because there is a chance for anal abscesses to recur or fistulas to develop, it’s important to attend all follow-up appointments. A 2019 study found that having a higher body mass index (BMI) may be correlated with abscesses recurring.
The recovery period for a drained rectal abscess is about 3 to 4 weeks.
If anal abscesses are left untreated, they can turn into painful anal fistulas that may require more surgical treatment.
According to the American Society of Colon and Rectal Surgeons, about 50 percent of people who have an anal abscess will eventually develop an anal fistula.
A fistula generally requires surgery.
There isn’t much known about how to prevent an anal abscess. But there are some steps you can take, including:
- taking measures to protect yourself from STIs and seeking prompt treatment
- using condoms or other barrier methods, especially during anal sex, to help prevent STIs that may cause anal abscesses
- practicing good hygiene and cleanliness in the anal area
- treating conditions like Crohn’s disease that may cause anal abscesses
Anal abscesses can cause complications, but they’re treatable. It’s important to understand the risk factors and closely monitor and manage any health conditions that may increase risk.
If you notice anal problems, contact a doctor to get treatment and to prevent them from becoming worse.
Perianal (Anal) Abscess: Causes, Symptoms, and More
An anal abscess, also known as a perianal or rectal abscess, occurs when a cavity in the anus becomes filled with pus.
Symptoms may include pain, constipation, or fever. Treatment may include drainage of the abscess or surgery.
A perianal abscess occurs when a cavity in the anus becomes filled with pus. The terms “anal abscess” and “rectal abscess” can also be used to describe this same condition.
Anal abscesses can cause:
- extreme pain
- fatigue
- rectal discharge
- fever
In some cases, they can result in painful anal fistulas. This occurs when the abscess breaks open on the surface of the skin. If an anal abscess isn’t drained, it can cause a lot of pain and may require surgery.
A rectal abscess can happen when a tear in that area becomes infected or an anal gland becomes blocked. A sexually transmitted infection (STI) can also cause anal abscesses.
Toddlers or children that have a history of anal fissures (tears in the anal sphincter) are also at a higher risk for developing anal abscesses later on. Such anal fissures might occur in children who have a history of constipation.
Anal abscesses are twice as likely in males compared with females.
Some other risk factors include:
- Crohn’s disease or ulcerative colitis, which are inflammatory bowel diseases that cause the body to attack healthy tissue
- diabetes
- a compromised immune system due to conditions like HIV or AIDS
- anal sex, which can increase the risk of anal abscesses
- use of the medication prednisone or other steroids
- current or recent chemotherapy or use of immunosuppressant medications
- constipation
- diarrhea
- smoking
This condition is likely underdiagnosed, as many people may not seek medical attention because they believe they may be experiencing hemorrhoids. It’s important to make an appointment with a doctor if you believe you have a perianal abscess.
If left untreated, anal abscesses can lead to severe complications, such as:
- an anal fistula, an atypical opening in the skin near the anus
- sepsis, a life threatening condition due to your body’s response to an infection
- Fournier’s gangrene, a rare but potentially life threatening infection
Throbbing and constant pain in the anal area can be one of the most common and immediately noticeable symptoms of an anal abscess.
The pain is usually accompanied by swelling in the anal area and greater pain during bowel movements.
Common signs of an anal abscess include:
- constant pain that can be dull, sharp, throbbing, or aching
- constipation
- rectal discharge or bleeding
- swelling or tenderness of the skin surrounding the anus
- fatigue
- fever
- chills
Some people may be able to feel a nodule or lump that’s red, swollen, and tender at the rim of the anus. Fever and chills can result from the infection. You may also have rectal bleeding or urinary symptoms, such as difficulty urinating.
Anal abscesses may also occur deeper in the rectum, most often in those who have inflammatory bowel diseases. This can result in some pain or discomfort in the abdominal area.
In toddlers, there typically aren’t many symptoms other than signs of discomfort or pain, which may cause a child to become irritable. A lump or nodule may also be visible or felt around the anal area.
Anal abscesses are most often diagnosed through a physical exam where a doctor checks the area for characteristic nodules. The doctor may also check for pain, redness, and swelling in the anal area and rule out other conditions.
In some people, there may not be any visible signs of the abscess on the surface of the skin around their anus. The doctor will instead use an instrument called an anoscope to look inside the anal canal and lower rectum.
Sometimes, the abscess may be deeper than a physical exam can find. The doctor may order imaging tests, such as a CT scan, MRI, or ultrasound, to get a better look.
Further tests may be necessary to make sure Crohn’s disease isn’t a contributing factor.
In these cases, blood and stool tests, imaging, and a colonoscopy may be needed. A colonoscopy is an outpatient procedure in which a doctor uses a flexible scope with a light to examine the colon and large intestine.
Anal abscesses rarely go away without treatment from a doctor.
Treatment may include drainage or surgery.
The most common and simple treatment is for a doctor to drain the pus from the infected area.
This can usually be done in the doctor’s office. The doctor will use medication to numb the area. Any uncomfortable pressure should be relieved, allowing the tissue to begin healing properly.
If there’s an extremely large anal abscess, surgery with anesthesia may be required. In some cases, a catheter may be used to make sure the abscess drains completely. Abscesses that have been drained are typically left open and don’t require stitches.
If you have diabetes or a weakened immune system, your doctor may ask you to stay in the hospital for a few days to watch for any infection.
Treatment following drainage may include:
- Medication. The doctor may prescribe antibiotics if you have a weakened immune system or if the infection has spread. Antibiotics are not considered sufficient to treat the infection on their own but may be prescribed after draining the abscess.
- Laxatives or fiber supplements. As you heal after draining the abscess, your doctor may recommend laxatives or fiber supplements to avoid constipation.
- Warm baths. After this procedure, the doctor may provide guidance on how to keep the area clean and may recommend a sitz bath. It’s recommended you take warm (not hot) baths. Sitting in warm water may help reduce swelling.
- Follow-up appointments. Because there is a chance for anal abscesses to recur or fistulas to develop, it’s important to attend all follow-up appointments. A 2019 study found that having a higher body mass index (BMI) may be correlated with abscesses recurring.
The recovery period for a drained rectal abscess is about 3 to 4 weeks.
If anal abscesses are left untreated, they can turn into painful anal fistulas that may require more surgical treatment.
According to the American Society of Colon and Rectal Surgeons, about 50 percent of people who have an anal abscess will eventually develop an anal fistula.
A fistula generally requires surgery.
There isn’t much known about how to prevent an anal abscess. But there are some steps you can take, including:
- taking measures to protect yourself from STIs and seeking prompt treatment
- using condoms or other barrier methods, especially during anal sex, to help prevent STIs that may cause anal abscesses
- practicing good hygiene and cleanliness in the anal area
- treating conditions like Crohn’s disease that may cause anal abscesses
Anal abscesses can cause complications, but they’re treatable. It’s important to understand the risk factors and closely monitor and manage any health conditions that may increase risk.
If you notice anal problems, contact a doctor to get treatment and to prevent them from becoming worse.
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What are rectal abscesses (paraproctitis)? Paraproctitis – purulent inflammation of the tissues surrounding the rectum. There are acute (first-time) and chronic paraproctitis (develops as a result of spontaneous or incorrect opening (treatment) of acute paraproctitis). Rectal abscesses are common in patients with pre-existing anorectal disease, diabetes, alcoholism, and neurological disease; infections in this area also most often develop in patients with acute leukemia, especially in the presence of neutropenia. Since the clinical picture may be regarded as a fever of unknown origin for a long period, it is important that in patients with unexplained fever, a thorough digital and endoscopic examination of the rectum is mandatory. Causes of rectal abscess (paraproctitis)There are many reasons for paraproctitis:
Through special glands located in the anus, the infection from the lumen of the rectum penetrates into the surrounding tissues. Acute paraproctitis occurs when the infection quickly penetrates into the pararectal (perrectal) cellular space. Depending on the immunity of a person, the size and location of the abscess can be different. An abscess can be located both directly under the skin of the perineum (subcutaneous – most often), and deep between the muscles of the perineum and buttocks (ischiorectal – sciatic-rectal, pelviorectal – pelvic-rectal, and as one of the types of pelvic-rectal – retrorectal (retrorectal)). Chronic paraproctitis often occurs with spontaneous or improper opening (treatment) of acute paraproctitis. Acute paraproctitis Acute paraproctitis occurs when the infection quickly penetrates into the pararectal cellular space – subcutaneous (most often), ischiorectal, pelviorectal, retrorectal (very rare). Symptoms of acute paraproctitis are primarily sharp pains that increase when walking, coughing, etc. The general condition worsens, especially with deep (ischiorectal, pelvic-rectal) abscesses, while there are practically no external signs – skin redness, fluctuations. With deep (high) ischiorectal and other acute paraproctitis, the patient’s condition may be severe – high fever, signs of intoxication, pain in the depths of the pelvis. Symptoms of acute paraproctitis The disease usually has an acute onset. Following a short prodromal period with malaise, weakness, headache, there is increasing pain in the rectum, perineum, or pelvis, accompanied by fever and chills. Ischiorectal abscess in the first days of the disease is manifested by general symptoms: chilling, feeling unwell, dull pain in the pelvis and rectum, aggravated by defecation; local changes – asymmetry of the buttocks, infiltration, skin hyperemia – appear at a late stage (5-6th day). The most severe is pelviorectal paraproctitis, in which the abscess is located deep in the pelvis. In the first days of the disease, general symptoms of inflammation predominate: fever, chills, headache, pain in the joints, in the pelvis, in the lower abdomen. Chronic paraproctitisChronic paraproctitis often occurs with spontaneous or improper opening (treatment) of acute paraproctitis. The internal opening of the abscess in the anal canal does not heal and a fistula remains. Healing can occur with a fragile scar, which, with minor trauma – cycling, constipation, etc. – abscess reappears, inflammation is not in the same place of the anal canal, while the localization of the abscess may be in another place in the perineum. After improper opening and treatment, the wound on the perineum does not heal – the rectal fistula remains, while re-infection with the intestinal flora occurs through the internal opening of the fistula. In most patients, the cause of the infection cannot be identified. Rectal abscesses are usually very painful, easily palpable, and often visible on examination. Treatment consists of an incision and drainage. DiagnosisThe first and main task of diagnosing acute paraproctitis is to recognize the presence and localization of an abscess in the cellular space surrounding the rectum based on the patient’s complaints, clinic and examination. The disease is detected during examination and digital examination of the rectum. To exclude complications of acute paraproctitis, women also need to consult a gynecologist, and men – a urologist. Treatment of acute paraproctitis is only surgical. Surgery should be performed immediately after diagnosis. The operation is performed under anesthesia. The purpose of the operation is to open the abscess (abscess) and remove the pus. After the operation, dressings are performed, antibiotics, vitamins, and immunity boosters are prescribed. However, opening an abscess is not a radical operation: after it, as a rule, repeated suppurations occur (chronic paraproctitis is formed). The reason for this phenomenon is the preservation of the inflammatory channel (fistula) between the rectum and surrounding tissues. For a complete cure, a second operation is required, performed in a specialized proctology hospital. As a result of such an operation, the connection between the intestinal cavity and the abscess is eliminated. It is called radical, because leads to a complete cure. ComplicationsUntimely surgical treatment of acute paraproctitis may lead to the development of complications: purulent destruction of the rectal wall and/or urethral wall in men, breakthrough of pus into the vagina in women. The most formidable complication is the breakthrough of pus into the pelvic cavity, which, if diagnosed late, can lead to death. After opening the abscess spontaneously or surgically without eliminating the purulent tract and the affected crypt, a fistula of the rectum is usually formed in the future. K61 – Abscess of the anus and rectum
Consult a healthcare professional before using any drug References
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Inflammation develops, an abscess forms. Therefore, a simple opening of abscesses from the outside, without sanitation of the internal inflamed area, does not lead to a lasting recovery.
Depending on the affected space, paraproctitis is distinguished by localization – subcutaneous, etc. The internal opening of the abscess is almost always one, there may be two or more external abscesses. In more than half of patients, the abscess is located on the border of the mucous membrane and skin.
The severity of the symptoms of acute paraproctitis depends on the location of the inflammatory process, its prevalence, the nature of the pathogen, and the reactivity of the body. With the localization of the abscess in the subcutaneous tissue, the clinical manifestations are more pronounced and definite: painful infiltrate in the anus, skin hyperemia, fever, usually force you to see a doctor in the first days after the onset of the disease.
Often the patient turns to a surgeon, urologist, women – to a gynecologist. Often they are treated for acute respiratory illness, influenza. The duration of this period sometimes reaches 10-12 days. In the future, there is an increase in pain in the pelvis and rectum, retention of stool, urine, and severe intoxication.
Such an operation can be performed in any surgical hospital.
If the fistula was not formed, but at the same time there was a focus of inflammation in the region of the anal glands and the intersphincter space, then after some time a relapse of acute paraproctitis occurs.
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What are rectal abscesses (paraproctitis)? Paraproctitis – purulent inflammation of the tissues surrounding the rectum. There are acute (first-time) and chronic paraproctitis (develops as a result of spontaneous or incorrect opening (treatment) of acute paraproctitis). Rectal abscesses are not uncommon in patients with pre-existing anorectal disease, diabetes, alcoholism, and neurological disease; infections in this area also most often develop in patients with acute leukemia, especially in the presence of neutropenia. Since the clinical picture may be regarded as a fever of unknown origin for a long period, it is important that in patients with unexplained fever, a thorough digital and endoscopic examination of the rectum is mandatory. Causes of rectal abscess (paraproctitis)There are many reasons for paraproctitis:
Through special glands located in the anus, the infection from the lumen of the rectum penetrates into the surrounding tissues. Acute paraproctitis occurs when the infection quickly penetrates into the pararectal (perrectal) cellular space. Depending on the immunity of a person, the size and location of the abscess can be different. An abscess can be located both directly under the skin of the perineum (subcutaneous – most often), and deep between the muscles of the perineum and buttocks (ischiorectal – sciatic-rectal, pelviorectal – pelvic-rectal, and as one of the types of pelvic-rectal – retrorectal (retrorectal)). Chronic paraproctitis often occurs with spontaneous or improper opening (treatment) of acute paraproctitis. Acute paraproctitis Acute paraproctitis occurs when the infection quickly penetrates into the pararectal cellular space – subcutaneous (most often), ischiorectal, pelviorectal, retrorectal (very rare). Symptoms of acute paraproctitis are primarily sharp pains that increase when walking, coughing, etc. The general condition worsens, especially with deep (ischiorectal, pelvic-rectal) abscesses, while there are practically no external signs – skin redness, fluctuations. With deep (high) ischiorectal and other acute paraproctitis, the patient’s condition may be severe – high fever, signs of intoxication, pain in the depths of the pelvis. Symptoms of acute paraproctitis The disease usually has an acute onset. Following a short prodromal period with malaise, weakness, headache, there is increasing pain in the rectum, perineum, or pelvis, accompanied by fever and chills. Ischiorectal abscess in the first days of the disease is manifested by general symptoms: chilling, feeling unwell, dull pain in the pelvis and rectum, aggravated by defecation; local changes – asymmetry of the buttocks, infiltration, skin hyperemia – appear at a late stage (5-6th day). The most severe is pelviorectal paraproctitis, in which the abscess is located deep in the pelvis. In the first days of the disease, general symptoms of inflammation predominate: fever, chills, headache, pain in the joints, in the pelvis, in the lower abdomen. Chronic paraproctitisChronic paraproctitis often occurs with spontaneous or improper opening (treatment) of acute paraproctitis. The internal opening of the abscess in the anal canal does not heal and a fistula remains. Healing can occur with a fragile scar, which, with minor trauma – cycling, constipation, etc. – abscess reappears, inflammation is not in the same place of the anal canal, while the localization of the abscess may be in another place in the perineum. After improper opening and treatment, the wound on the perineum does not heal – the rectal fistula remains, while re-infection with the intestinal flora occurs through the internal opening of the fistula. In most patients, the cause of the infection cannot be identified. Rectal abscesses are usually very painful, easily palpable, and often visible on examination. Treatment consists of an incision and drainage. DiagnosisThe first and main task of diagnosing acute paraproctitis is to recognize the presence and localization of an abscess in the cellular space surrounding the rectum based on the patient’s complaints, clinic and examination. The disease is detected during examination and digital examination of the rectum. To exclude complications of acute paraproctitis, women also need to consult a gynecologist, and men – a urologist. Treatment of acute paraproctitis is only surgical. Surgery should be performed immediately after diagnosis. The operation is performed under anesthesia. The purpose of the operation is to open the abscess (abscess) and remove the pus. After the operation, dressings are performed, antibiotics, vitamins, and immunity boosters are prescribed. However, opening an abscess is not a radical operation: after it, as a rule, repeated suppurations occur (chronic paraproctitis is formed). The reason for this phenomenon is the preservation of the inflammatory channel (fistula) between the rectum and surrounding tissues. For a complete cure, a second operation is required, performed in a specialized proctology hospital. As a result of such an operation, the connection between the intestinal cavity and the abscess is eliminated. It is called radical, because leads to a complete cure. ComplicationsUntimely surgical treatment of acute paraproctitis may lead to the development of complications: purulent destruction of the rectal wall and/or urethral wall in men, breakthrough of pus into the vagina in women. The most formidable complication is the breakthrough of pus into the pelvic cavity, which, if diagnosed late, can lead to death. After opening the abscess spontaneously or surgically without eliminating the purulent tract and the affected crypt, a fistula of the rectum is usually formed in the future. K61 – Abscess of the anus and rectum
Consult a healthcare professional before using any drug References
|
Inflammation develops, an abscess forms. Therefore, a simple opening of abscesses from the outside, without sanitation of the internal inflamed area, does not lead to a lasting recovery.
Depending on the affected space, paraproctitis is distinguished by localization – subcutaneous, etc. The internal opening of the abscess is almost always one, there may be two or more external abscesses. In more than half of patients, the abscess is located on the border of the mucous membrane and skin.
The severity of the symptoms of acute paraproctitis depends on the location of the inflammatory process, its prevalence, the nature of the pathogen, and the reactivity of the body. With the localization of the abscess in the subcutaneous tissue, the clinical manifestations are more pronounced and definite: painful infiltrate in the anus, skin hyperemia, fever, usually force you to see a doctor in the first days after the onset of the disease.
Often the patient turns to a surgeon, urologist, women – to a gynecologist. Often they are treated for acute respiratory illness, influenza. The duration of this period sometimes reaches 10-12 days. In the future, there is an increase in pain in the pelvis and rectum, retention of stool, urine, and severe intoxication.
Such an operation can be performed in any surgical hospital.
If the fistula was not formed, but at the same time there was a focus of inflammation in the region of the anal glands and the intersphincter space, then after some time a relapse of acute paraproctitis occurs.
20 ml: fl. 8 pcs.
No.: P N001974/01
20 ml: fl. 8 pcs.