Encyclopedia

Paraproctitis

Paraproctitis is an inflammation of tissue around the rectum.

The disease develops due to the passage of hard and large faecal masses or due to the development of infection in sores on the mucous membrane of the rectum.

The acute form of the disease in most cases is observed in people of working age, with 75% of those affected being in the age group of 30-60 years.

Men get sick 3 times more often than women.

The onset of the disease is acute and manifests itself in the appearance of pain in the anus, which initially subsides when sitting and walking, but subsequently intensifies and gradually becomes permanent.

Very soon, those affected develop a fever, chills and general malaise, and their blood sugar level changes.

Sometimes these symptoms are accompanied by a delay in bowel movement and a reduced amount of diuresis. But in some cases, the characteristic clinical manifestations of the disease are not manifested.

What are the causes?

The disease is most often caused by penetration into the tissues through the rectal sinuses located in the lower part of the rectum of pathogenic microorganisms: staphylococci, Escherichia coli, protozoa, streptococci, Actinomyces israelii, the causative agent of actinomycosis.

From here the infection spreads to the tissue and eventually ulcers form. They can appear under the skin or mucous membrane.

The penetration of infection into the tissues is the reason for the development of the inflammatory process and the appearance of abscesses.

The formation swells, increases in size and as a result of penetration of pus into the surrounding tissues, which also causes the characteristic symptoms.

Abscesses have localization:

• Subcutaneous;
• Submucosal;
• Sciatic-rectal;
• Frontal side of the rectum;
• In the pelvic part of the rectum;

Cases of the appearance of a purulent abscess in the thigh, scrotum and anterior abdominal wall have also been described, in which a rupture may occur, from which the entire contents of the abscess may leak into the abdominal cavity.

When an abscess develops in the pelvic part of the rectum, anaerobic bacteria – fusobacteria, bacteroides and peptococci – begin to multiply in it.

Microorganisms cause the occurrence of putrefactive processes in the fabric, and the same affect increasingly large spaces.

The unfavorable development of the disease leads to inflammation of the connective and muscle tissue.

Such development of an acute inflammatory process is the most dangerous, because it causes tissue necrosis, releasing no longer pus, but detritus – remains of dead blood cells, fascia and muscle fibers.< /p>

The most dangerous form of the disease is caused by the causative agents of gas gangrene – clostridia.

Inflammation can be caused by viruses, chlamydia, gardenella, mycoplasma.

Most often, the acute form of paraproctitis is caused by pathogenic microflora of a mixed nature.

In some cases, a specific infection of tuberculous origin develops, which is caused by the penetration of Mycobacterium tuberculosis from the lungs.

An entrance door for infection is often the anal crypts, as well as injuries to the inner membrane of the rectum.

The internal opening of the fistula is formed in the crypt, then by means of the lymph flow and the blood, the infection spreads to the surrounding tissue.

Risk factors:

• Weakening of the immune system;
• Alcoholism;
• Hemorrhoids;
• Cryptitis;
• Anal fissures;
• Constipation;
• Diarrhea;
• Chronic foci of infection;

Treatment of paraproctitis

Treatment of the disease is mainly surgical and consists in opening the abscess and removing the pus.

Cleaning the site of infection, disinfection of the inflamed area – the most reliable method of treatment.

The conservative method of treatment is sometimes applied to subcutaneous abscesses by applying ointments locally, but this is not a 100% guarantee of eliminating the source of infection.

The difficulty of conservative treatment of paraproctitis lies in the fact that the abscess is caused by a pathogenic mycoflora of mixed origin, and not by a specific infectious organism.

The use of antibiotics does not always achieve complete suppression of the activity of all the microorganisms that cause the infection.

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