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Paraproctitis: causes, symptoms and treatment methods (without surgery), complications

The growing pains in the perineum, high fever and problematic sitting on a chair are problems, though delicate, but so disturbing the usual pace of life, that make even the most shy people seek medical help.

In a quarter of cases of pathology of the rectum, the proctologist diagnoses paraproctitis and prescribes surgery.

In search of the possibility of avoiding a surgical intervention, the patient must clearly understand the danger of complications of paraproctitis in the event of untimely or inadequate treatment.


Paraproctitis: what is it?

Paraproctitis: what is it? photo 1

Paraproctitis is acute, with the absence or ineffectiveness of the treatment, the purulent inflammation of the pararectal fiber, which becomes chronic, becomes chronic. In other words, an abscess, an abscess, forms in the perineal space filled with fatty tissue.

The purulent process that has begun cannot be stopped: in any case, necrosis of infected tissues occurs. In addition, acute paraproctitis has a high chance of becoming chronic.

Spontaneous opening of an abscess gives only temporary relief, and repeated suppuration is fraught with the formation of a fistula, which goes either into the rectum or through the skin of the anal zone.

Paraproctitis is most commonly diagnosed in men. It is extremely rare that the disease develops in children after prompt elimination of congenital defects in the development of the anus and narrowing of the rectum.

The severity of symptoms of paraproctitis, the lack of chances for self-healing and the effectiveness of non-surgical therapy, as well as serious complications, require immediate medical attention when the first symptoms of the disease appear and skilled surgical care.

Forms of pathology

  • with the flow - acute (first formed) and chronic (formed fistula);
  • the depth of the location of the pathology is superficial, deep;
  • localization of purulent foci - subcutaneous, submucosal, intraspinal (located between the fibers of the external and internal sphincter), isio-rectal (abscess located in the perineum, outside the anal sphincter), pelvio-rectal (high location, high threat of total purulent process);
  • by the presence of a fistulous exit - incomplete (there is only an entrance through the anal crypt) and complete (an abscess has found an exit through the skin, into the abdominal space or into the lumen of the rectum);
  • in relation to the fistula to the anal sphincter, intra-, extra- and transsphinctral;
  • according to the complexity of the structure of the fistulous passages - simple and complex (the presence of several moves, leakages and purulent pockets).

Causes of paraproctitis

Causes of paraproctitis

The main culprits of paraproctitis are anaerobic bacteria: E. coli, often in collaboration with staphylococci and streptococci.

The infection enters the tissue surrounding the rectum through the ducts of the glands (morgan crypts) that open inside the anal canal or through microdamages of the rectal mucosa.

Hematogenous / lymphogenous pathway of infection is not excluded. The causative agent of chronic foci of infection (caries, sinusitis, chronic tonsillitis) with the blood or lymph reaches the anal zone and multiplies in the periosteral fiber tissue.

Factors provoking the development of paraproctitis:

  • hemorrhoids,
  • nonspecific ulcerative colitis,
  • anal and rectal fissures,
  • Crohn's disease,
  • constipation
  • reduced immunity
  • arteriosclerosis of rectal vessels,
  • gynecological diseases in women and prostatitis in men
  • diabetes,
  • surgery on the rectum.

Symptoms and signs of paraproctitis, photo

Acute paraproctitis always begins suddenly.

Common symptoms:

  1. temperature rise,
  2. weakness,
  3. muscle pain, lack of appetite.

Specific signs of paraproctitis:

  1. sharp pains of a throbbing / jerking nature in the rectal area, extending during bowel movements to the entire pelvic area;
  2. painful urination;
  3. upset stools and painful urge to empty the bowels;
  4. with a superficial arrangement of a purulent focus - swelling and redness of the skin with the possible opening and expiration of pus.
Symptoms of paraproctitis, photo

Symptoms of paraproctitis, photo

Self-opening of an abscess can occur through the skin (the most favorable option), into the lumen of the vagina in women, into the rectum, into the abdominal space with the formation of peritonitis.

The walls of the purulent cavity and the fistulous course are gradually lined with epithelium, chronic paraproctitis is formed with periodic exacerbation and release of purulent contents.

During remission, it is characterized by an imaginary recovery: the patient’s well-being is normalized, working capacity is restored, the wound is healed by scar tissue. However, recurrent exacerbations can lead to insomnia, neurasthenia, and impotence in men.

Complications of paraproctitis, photo 3

Complications of paraproctitis, photo 3

Diagnosis of paraproctitis

Diagnostic examination is designed to accurately determine the localization of the fistula and the degree of damage to the sphincter muscle fibers for the selection of effective treatment of paraproctitis.

A patient with suspected paraproctitis is:

  • digital examination of the rectum (identification of the internal mouth of the fistula);
  • probe examination;
  • transrectal ultrasound;
  • fistulography.

Paraproctitis treatment and surgery

Operation paraproctitis, photo 4

Operation paraproctitis, photo 4

For many patients, the question arises: is surgery required for paraproctitis? In this case, the answer is categorical - treatment of paraproctitis without surgery is impossible, and the delay only aggravates the purulent process.

Radical treatment is carried out in two stages:

  1. Opening of an abscess and removal of pus, often with draining. In acute paraproctitis, after an operation to open a purulent cavity, a fistula is almost always formed.
  2. Removal of the fistulous passage and closing the connection between the rectum and the purulent cavity.

Often, with surgical removal of the fistula, hemorrhoids are surgically treated.

Surgical intervention is tolerated fairly easily, the postoperative period is not very painful.

At the same time antibiotic therapy and immunostimulation are carried out.

Only such treatment of paraproctitis, involving two operations under general anesthesia and drug therapy, provides a complete cure for the patient.

Complications of paraproctitis

Complications of paraproctitis When the first signs of paraproctitis appear, emergency surgical assistance is necessary. From the timing of its delivery depends on the prognosis of the disease.

Chronic paraproctitis is characterized by a high risk of developing complications:

  • Spontaneous opening of the abscess.
  • Purulent fusion and necrosis of the walls of the vagina, urethra.
  • The output of fecal masses in the periurnal intestinal tissue through the necrotic wall of the rectum, the lightning-fast spread of a purulent process.
  • Breakthrough abscess in the abdominal space and the development of peritonitis, threatening to death.
  • Failure of the anal sphincter due to severe damage to its fibers, leakage of feces.
  • The growth of scar tissue and a decrease in the elasticity of the walls of the anal canal.
  • Cancer degeneration in the presence of a fistula for more than 5 years.

Prevention of paraproctitis

  1. Timely and complete treatment of rectal pathology.
  2. Fight against constipation.
  3. Proper hygiene of the anal area to avoid the formation of anal fissures.
  4. Maintenance of immunity, elimination of chronic foci of infection in the body.

Paraproctitis ICD 10

The international classification of diseases of pathology is:

Class XI. Diseases of the digestive organs (K00 — K93)

K55-K63 - Other intestinal diseases

K61 - Abscess of the anus and rectum (Including: abscess or phlegmon of the anus and rectum with or without a fistula)

  • K61.0 Anal (anal) abscess

K62 - Other diseases of the anus and rectum

  • K62.8 Other specified diseases of the anus and rectum / perforation (non-rhythmic) of the rectum / proctitis BDU

2017-01-12 02:30:17
I was operated on parapractite, but for some reason the analysis was not removed.

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