Inflammation of pararectal tissue caused by infection is called paraproctitis. Infection in 97-98% of cases of microorganisms( staphylococcus, E. coli), and with putrefactive paraproctitis, the infection is caused by anaerobic microorganisms. Paths of infection from the lumen of the rectum are the anal glands located in the blink holes. Depending on the depth of penetration of the infection into the cellulose, different types of acute and chronic diseases are distinguished.
In terms of distribution, submucosal paraproctitis occurs immediately after subcutaneous, which affects more than 50% of all those suffering from this disease. Determine it in the finger research of the rectum. This type of abscess is substantially excreted in the lumen of the intestine, and the pus can spread both downward and upward along the mucous membrane. Often there is a spontaneous dissection of the abscess of the mucous membrane and in this case, with a good quality drainage, complete recovery may occur.
Symptoms of submucosal paraproctitis are practically:
- General malaise, headache, aching muscles and slight increase in body temperature.
- Pain symptoms in the rectum area, increasing with defecation.
As the size of the ulcer grows, the pain becomes stronger. When the mucosa breaks from the anus, pus with traces of blood is excreted and the healing process begins. In general, of all kinds of purulent inflammation of the perianal region, submucosal paraproctitis is the only disease that lends itself to self-healing. However, an exceptional method, in which it is possible with 100% probability to guarantee a complete cure, is the operation.
The very operation of the submucosal type of the disease is carried out under general anesthesia and consists in removing pus from the dissected abscess in the mucosa. After the operation, the wound is left open and tampons are placed in the cavity. This technique of surgical intervention is dictated by the goal of improving the outflow of purulent contents and accelerating the process of mucosal regeneration. To ensure rest, special drugs are used that delay defecation.
Subcutaneous submucosal paraproctitis
With the development of inflammation on the border between the skin and the mucous membrane, subcutaneous submucosal paraproctitis occurs. Symptoms that characterize it are similar to the subcutaneous type of the disease and treatment is also provided only for cardinal surgery. When preparing for surgery, it is desirable to put a cleansing enema, but sometimes it is difficult to do because of strong pain. After carrying out anesthesia, the doctor treats the operating field and the lumen of the distal rectum, an antiseptic drug. Using the rectal mirror, the anal canal and the muscular wall of the rectal mucosa are examined. The length of the incision should be at least 3-4 centimeters, but in any case it should completely capture the area of the inflammatory process. The cut of the mucosa is shallow, penetrating to the muscular layer, so as not to damage the anal sphincter. The purulent cavity is completely opened. To prevent the edges of mucosal wounds from closing, excision is performed. In this case, the affected crypt mucosa is also excised.
Correct and timely operation of submucosal paraproctitis provides a guaranteed cure. However, if you simply open and clean the abscess in the mucosa, there is always the risk of re-inflammation, since there is a primary opening of the mucosa and a connection with the rectum. Postoperative treatment for subcutaneous-submucosal paraproctitis is also similar to care after removal of subcutaneous abscess.