Paraproctitis

General description of the disease

This is an acute inflammation of the pararectal cell tissue. Approximately 30% of all rectal diseases are caused by it. In most cases, paraproctitis is caused by polymicrobial flora. During inoculation of purulent contents, staphylococci, Escherichia coli, Gram-positive and Gram-negative bacilli are usually found. As a rule, the disease begins abruptly, and is accompanied by pronounced symptoms, discomfort, and severe pain. Requires urgent and immediate treatment.

The reasons that provoke the onset of paraproctitis

The cause of paraproctitis is an infection that gets into the soft tissues around the anus, causing inflammation and abscesses. The infection penetrates through wounds caused by diarrhea or constipation, hemorrhoids, anal trauma. Sometimes the exact cause of the onset of the disease in a particular person is difficult to establish. Even an accidentally swallowed bone or egg scarloop, which comes out with feces, can injure the intestines.

Among other common causes of paraproctitis, doctors also call the following:

• expansion and inflammation of hemorrhoidal veins;
• anal fissure;
• inflammatory diseases of the rectum and other parts of the intestine;
• stool disorders (diarrhea, constipation);
• immunodeficiency;
• chronic inflammation in any system of the body.

Types of paraproctitis

Depending on the location, there are several classifications of the disease.

1. 1 Subcutaneous paraproctitis… An abscess appears directly under the skin, signs of the disease are noticeable even on examination, this is the most common type of disease.
2. 2 Submucous paraproctitis… Purulent paraproctitis occurs in the rectum under the mucous membrane.
3. 3 Ischiorectal… The inflammation spreads to the muscle that lifts the anus.
4. 4 Pelviorectal… The inflammation spreads to the muscles of the lifting of the anus and acts through it on the pelvic muscles. Due to its widespread occurrence, this type of paraproctitis is the most dangerous.

In addition, inflammation can be deep or superficial.

Symptoms of paraproctitis

This disease begins suddenly and is characterized by violent clinical manifestations. Here are the general symptoms that may appear in the first hours after the onset of the disease:

• pain around the rectum and anus. Pain can penetrate into the groin and perineum, as well as into the abdominal cavity; during bowel movements, it increases.
• frequent and false urge to defecate, but constipation is also possible.
• painful urination;
• signs of intoxication such as fever, weakness, pallor, loss of appetite and dizziness, the temperature can rise to 39 degrees.

These symptoms are manifested in all types of paraproctitis and do not depend on its location. However, each type of pathology develops its own typical symptoms that help determine exactly where the inflammation originated.

RџSЂRё subcutaneous paraproctitiswhen the abscess is located near the anus under the skin, the symptoms are most noticeable: painful swelling in the anus, with reddening of the skin above it. The pains gradually increase, acquiring an intense pulsating character, bringing enormous discomfort when sitting, defecating. These processes are accompanied by severe pain. This form of abscess is the most common.

Submucosal abscess located under the rectal mucosa. Symptoms of this type of location are similar to a subcutaneous abscess, but pain and skin changes are less pronounced.

RџSЂRё ischeorectal abscess purulent focus is located above the muscle that raises the anus. Due to a deep abscess, local symptoms are more vague: dull throbbing pain in the pelvic and rectal region, which increases during bowel movements. Skin redness, swelling occurs 5-6 days after the onset of pain. The general feeling is heavy: the temperature can rise to 38 degrees, severe intoxication is observed.

The most difficult is considered pelviorectal abscess… This is a rare form of acute abscess, when a purulent focus is located over the muscles that form the pelvic floor, it is separated from the abdominal cavity by a thin layer of the peritoneum. The onset of the disease is accompanied by high fever, chills, and joint pain. Local symptoms: pain in the hip joint and abdominal cavity. After 10-12 days, the pain intensifies, stool and urine retention occurs.

Some people are diagnosed with isolated necrotizing paraproctitis… This form is characterized by the rapid spread of the abscess, accompanied by extensive necrosis of soft tissues and requiring their removal, after which large scars remain, requiring the intervention of a plastic surgeon.

Paraproctitis in children

Most often, paraproctitis occurs in people over 20 years old, but children are also at risk. Symptoms in children are the same as in adult patients, however, it is more difficult to diagnose the disease, since babies cannot always describe what exactly worries them.

Parents should pay special attention to fever, frequent crying from the infant, especially during bowel movements, and constipation. As a rule, children suffer from subcutaneous paraproctitis, therefore, the skin around the anus is red and swollen.

The reasons for the formation of paraproctitis in children:

• abnormalities of the glands in the rectum;
• low immunity;
• inflammation of the intestines and respiratory system;
• intestinal dysbiosis.

Complications with paraproctitis

If purulent paraproctitis does not break out on time, dangerous complications may arise:

• a purulent formation can damage the intestinal walls and vaginal walls in women;
• with subcutaneous localization, the destruction of the abscess can be external, which leads to additional infections;
• damage to fatty tissue in the pelvic region;
• damage to the urethra caused by its purulent infiltration;
• peritonitis due to the rapid spread of inflammation to the abdominal cavity;

The postoperative period can also be challenging. Even if the surgeon adheres to all the rules of surgical intervention, bleeding, infectious complications and other postoperative problems may appear.

Prevention of paraproctitis

There are no special preventive measures for this disease. It is necessary to timely and correctly treat all rectal disorders. Chronic infections of other body systems should not be ignored. Proper intimate hygiene is very important. It is necessary to regularly visit a doctor for a preventive examination, and not to delay the trip to a specialist when the body begins to give alarming signs: pain, discomfort, weakness, etc.

Diagnostics

The diagnosis of “paraproctitis”, as a rule, is made on the basis of the study of the clinical picture, as well as after a digital examination of the rectum. During this examination, a doctor wearing special gloves inserts a finger into the anus and easily feels the walls of the rectum. In this case, the patient can lie on his side or on his back, in a gynecological chair. This is often enough.

In rare cases, especially with very advanced or complicated forms of the disease, an instrumental examination is prescribed using rectoscopy (endoscopic examination) or ultrasonography (insertion of an ultrasound probe into the rectum).

Treatment of paraproctitis in official medicine

Acute paraproctitis is a medical emergency and requires surgical treatment.

Anesthesia plays a very important role in the treatment of acute paraproctitis. The operation is performed under general anesthesia, and doctors should relax the patient’s muscles as much as possible. Surgery for paraproctitis requires compliance with some important rules to remove purulent inflammation:

• abscess incision;
• abscess drainage;
• detection of the affected area of ​​the intestine and its removal.

Sometimes inexperienced doctors perform only incision and drainage of the abscess to treat paraproctitis, which can lead to either a relapse or anal fistula.

During the postoperative period, the patient should take antibiotics to prevent recurrence of paraproctitis. They also prevent other body systems from becoming infected and from complications such as sepsis or peritonitis.

During the recovery period, it is very important to maintain proper intimate hygiene. The rectal area is washed twice a day in the morning and in the evening and after each bowel movement to prevent infection of the postoperative wound.

Attention!

The administration is not responsible for any attempt to use the information provided, and does not guarantee that it will not harm you personally. The materials cannot be used to prescribe treatment and make a diagnosis. Always consult your specialist doctor!