The organisms can enter the peritoneal region in several ways:
- Through a gap in the rectal mucosa.
- By the ducts of the anal glands that enter the rectal cavity.
- If there is an infection in the body through the flow of blood.
The development of acute purulent paraproctitis provokes the presence of such factors as weakened immunity, bowel problems in the form of constipation and polyps, as well as the presence of chronic inflammatory processes in the human body and rectum disease. The presence of at least one of these factors creates favorable conditions for
for active propagation of the infection and the onset of the disease.
Causes of purulent paraproctitis
Among the main causes of inducing abscesses of the rectum come first places:
- Available diseases of the anus( cracks, hemorrhoids).
- Violations of personal hygiene.
- Manipulation in the anus, accompanied by traumatic consequences.
Rapid penetration of infection into the pararectal cells is the cause of an acute inflammatory process. The size and location of the focus of infection depends on the human immunity. The most often there is an abscess in the subcutaneous cellular space. In this case, the internal opening of the abscess is always only in the singular, and the outer one can be several.
The development of paraproctitis can be facilitated by large physical exertion with lifting of weights, enthusiasm for acute and fatty foods, alcohol. Weakened immunity as a result of a disease can also provoke the development of an inflammatory process. There are cases when an ordinary acute respiratory viral infection leads to paraproctitis.
The purulent process begins with reddening of the skin around the anus, pains in the anus, amplified by the exit of stool. Such a symptomatology is characteristic of subcutaneous paraproctitis. In other types of purulent inflammation( pelviorectal, ischiorectal) at the onset of the disease, the temperature may be low, the pain sensations are expressed unclearly and without a clear definition of the location. But with the further development of the disease, a painful to the touch appears on the site of the lesion, an increase in body temperature becomes significant and intoxication of the organism as a whole is possible. Given that the consequences of these types of inflammatory process due to their deep location are more serious than with an external purulent paraproctitis, it is necessary to consult a doctor even at the first signs of the disease.
Treatment of purulent paraproctitis
When examined externally, the doctor examines the area of the buttocks. The presence of abscess, swelling of the rectum, the soreness of one or another zone is determined by finger examination. If the clinical picture remains unclear, further studies are carried out. This can be fistulography and ultrasound examination with a rectal sensor. The ultrasound scans the location and dimensions of the abscess. Fistulography for examination of the fistula by X-ray diffraction using X-ray contrast medium is performed in chronic paraproctitis. Having established the diagnosis, urgent surgery is appointed.
Treatment of acute purulent paraproctitis consists in dissection of the abscess, purification of the wound from pus and removal of the inflamed area. It is also possible to perform the operation in several stages, at which the abscess is initially opened and drained, and then the affected anal sinuses and glands are removed, as well as the fistulous course. The choice of the procedure for the operation depends on the accuracy of the diagnosis of the general condition of the patient and how much the surrounding tissues are affected.
The second stage of the operation is carried out a week after the first surgery. In chronic purulent paraproctitis, an abscess is opened and drainage followed by excision of the fistula. Treatment in the postoperative period of purulent paraproctitis consists in daily washing and applying bandages with antiseptic ointments or impregnated with appropriate solutions. The course can take from seven to ten days in a hospital. At home, the treatment is continued, using baths, microclysters, suppositories and tampons.