Purulent inflammation of the rectum tissues( paraproctitis) is a common disease. The inflammation itself is located in the depth, between the muscles of the perineum and the buttocks, and in direct proximity to the surface of the skin. From the location of inflammation distinguish different types of this disease.
Ischiorectal paraproctitis is in second place in terms of distribution among other species, and in half of cases of acute paraproctitis diseases it is diagnosed. The severity of the disease, it refers to a relatively easy.
Acute ischiorectal paraproctitis is characterized by the following symptoms:
- Anxiety and weakness, decreased appetite.
- Increased body temperature, initially insignificant, and with further development of the disease, can rise to 40 ° C.In this case, the heart rate and respiration rate is accelerated.
- Deep blunt rubbers in the anus, rectum, perineum.
Sometimes the site of localization of ischiorectal inflammation is difficult to determine. Six days after the onset of the disease, redness appears, puffiness on one of the buttocks and palpation painful dense infiltration is felt. To clarify the localization of purulent ishiorectal paraproctitis, in addition to research using the finger method of the rectum, ultrasound is performed. With the help of fistulography determine the size and exact location of the abscess, stroke length and how close it is to the sphincter of the rectum. The fact of inflammation is found in an increased number of leukocytes, accelerated by ESR in blood analysis( general).
The transition to the chronic form of ischiorectal paraproctitis is indicated by the presence of a fistula, which can be complete or incomplete, located inside or outside. Regardless of the speed of the course of the illness, surgical intervention is also included in the course of curing for the disease. In acute purulent ischiorectal paraproctitis, the mucosal compaction is very painful, it is at the level of the border between the rectum and the anal canal and higher. The correct sign is the defeat of the ileo-rectal fossa of the perineal region.
In acute ischiorectal paraproctitis, a one-stage operation is indicated if the location of the inflammation is accurately determined by a specialist, and the infection has not yet penetrated into the surrounding tissue and the process of inflammation has not begun. Otherwise, surgical intervention in two stages, first open and drain the abscess, and after a period of 5-7 days, removal of the inflammatory anal sinus and excision of the anal glands entering into it.
Retrorectal paraproctitis
An abscess located in the prescalar tissue is classified as a posterior-rectal or retrectectal paraproctitis. The clinical picture of this disease is characterized by a marked pain syndrome in the rectum and sacrum, which is enhanced by the release of stool. In the study, the finger of the region of the posterior perineum responds with a sharp pain. With this type of illness, urgent hospitalization and immediate surgery are needed.
For a special study apply only sigmoidoscopy. At the same time, the internal fistula opening, infiltration, integrity and smoothing of the walls are determined. As a percentage, retrectectal paraproctitis is diagnosed in only 1.5-2.5% of all cases. The specific operation of this type of inflammation is that the incision is carried out at a distance of 1 cm from the coccyx, crossing the anal-coccyx ligament and removing pus.
Pelvoreectal paraproctitis
Pelviorectal paraproctitis refers to extremely rare diseases. The focus of inflammation is in the space between the ankle-lift muscles and the peritoneum of the pelvic floor. Pelvic or rectum or parviorectal paraproctitis is very difficult to diagnose and it belongs to the most complex form. External signs are absent at the same time and at the same time patients complain of sensation of heaviness in the pelvis, pain in this area.
With the further development of the disease, there are symptoms similar to the clinical picture in acute appendicitis or gynecological disease. Possible intermittent fever, acute pain with urination, unstable pain during defecation. In finger research, it is possible to examine only the lower edge of the infiltrate, and the upper boundary of the formed densification can not be investigated.
When the disease progresses and the infiltrate moves down the upper surface of the muscle, the symptoms become similar to the pelviorectal paraproctitis. To confirm the diagnosis, use computer or magnetic resonance imaging and ultrasound. Operative treatment is carried out only in two stages, and among all the operations concerning ischiorectal, it refers to the most complex. Additional drainage of the retroperitoneal and pelvic space is also possible.