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The paraproctitis (from Greek paraproctitis, from Greek paraproktos — "about an anus" and itis — "inflammation") is a purulent inflammation of cellulose which surrounds a rectum. The disease of a paraproctitis makes 15% among all damages of a rectum. Distinguish acute and chronic forms of a disease. The chronic paraproctitis usually arises after not cured acute form.
The disease is caused by influence of microorganisms – the stafilokokk, streptococci and protiums getting into a rectum through proctal glands, cracks of a mucous membrane, and also with a blood flow from the next inflamed bodies. Thereof in perirectal fabrics there is an abscess around which hypostasis and reddening is formed. Specific infections, for example tuberculosis can sometimes become an origin of a disease. In the absence of timely treatment, the chronic paraproctitis can develop, pus can get to an abdominal cavity. Treatment of a paraproctitis – operational which has to be carried out as soon as possible after diagnosing of a disease.
Hemorrhoids, cryptitis, existence of proctal cracks are the reasons of a paraproctitis. Sometimes the paraproctitis can be caused by manipulations which injured the proctal channel, and non-compliance with rules of personal hygiene.
In the place of distribution of an infection distinguish 4 types of a paraproctitis – hypodermic, submucosal, ischiorectal and tazovo-pryamokishechny. At a hypodermic paraproctitis the abscess is located in cellulose near a sphincter. The submucosal paraproctitis is characterized by an arrangement of purulent process under a mucous membrane of a large intestine. In cellulose of sciatic area the abscess is formed at an ischiorectal paraproctitis. The most deeply inflammatory process gets at a tazovo-pryamokishechny paraproctitis – into pelvic cellulose.
Paraproctitis symptoms: a swelling and erubescence, morbidity of the place of formation of an abscess, sharp pains which amplify when walking, sitting and sometimes during defecation. There is a weakness, symptoms of intoxication of an organism, temperature – subfebrile, pains in the field of a basin can be observed. Degree and character of pain depends on the place of distribution of purulent process. The general state painfully is the strongest suffers at the deep abscesses located in a basin and it is more difficult to find them.
If after emergence of unpleasant symptoms diagnosis of a paraproctitis and the subsequent treatment is not carried out, then pains tend to amplify, the ischuria and a chair can be observed. If not to carry out necessary treatment, the abscess can break and pus will get to a peritoneum.
The paraproctitis usually comes to an end with recovery if opening of an abscess in a wall of a gut cicatrized, in other cases there is a chronic paraproctitis which is followed by forming of fistula of a rectum.
Diagnosis of a paraproctitis
The forecast of treatment of a paraproctitis depends on degree of neglect of a disease. The surgeon or the coloproctologist will listen to complaints of the patient, will conduct manual rectal research. It is not difficult to diagnose a hypodermic paraproctitis, at survey infiltrate and reddening, painful is visible at a palpation. The submucosal type of a paraproctitis is diagnosed by also manual research of a rectum which will reveal painful consolidation in one of gut walls. The ultrasonografiya is applied to diagnosing of two other types of a disease.
Treatment of a paraproctitis
The disease only of a surgical way is treated. In surgical department the abscess is opened, pus is removed. Pains fall down at once and the patient recovers. However there is a probability that fistula is formed and it is necessary to perform one more operation. Coloproctologists usually perform radical operation when except opening of abscess also its communication with a gut cavity is liquidated. This operation leads to an absolute recovery.
After operation by the patient the sparing diet, the drugs regulating a chair, vitamins, heat sedentary baths, physical therapy is recommended. Also the course of treatment can be appointed antibiotics.
Operational treatment of a paraproctitis has the favorable forecast, on condition of carrying out timely operation by the highly skilled doctor.
Complications of a paraproctitis
If a paraproctitis not to treat timely, then it can lead to development of a chronic paraproctitis, sepsis, the inflammation can pass to other bodies of urinogenital system. Complications of a paraproctitis can be shown in development of purulent destruction of walls of a rectum, at men damages of a wall of an urethra are observed, and at women pus can get into a vagina. Therefore it is necessary to treat a paraproctitis as soon as possible.