perianal abscess
Introduction
Introduction to perianal abscess Anal canal, acute suppurative infection in or around the soft tissue around the rectum, and the formation of abscess, called anal canal, abscess around the rectum. It is characterized by self-rupture, or anal fistula often formed after surgical incision and drainage. It is a common anorectal disease, and it is also an acute phase of anal canal and rectal inflammation. The anal fistula is a chronic phase. Common pathogens include Escherichia coli, Staphylococcus aureus, Streptococcus and Pseudomonas aeruginosa, occasionally anaerobic bacteria and Mycobacterium tuberculosis, often mixed infections of various bacteria, subcutaneous abscess around the anus is most common, mostly by anal gland The infection is formed by outward or direct outward diffusion of the lower part of the external sphincter. basic knowledge The proportion of illness: 0.28% Susceptible people: no specific population Mode of infection: non-infectious Complications: anal fistula, ischial rectal abscess
Cause
Cause of perianal abscess
There are many causes of perianal abscess, the main reasons are as follows:
Iatrogenic factors (8%):
Clinically, iatrogenic anal abscess around the rectum is not uncommon. 1 Intra-invasive sputum or injection therapy, submucosal abscess due to improper operation or unclean infection. 2 Injecting chemical drugs around the rectum to cause tissue necrosis, resulting in abscess around the rectum. 3 sigmoidoscopy, causing peritoneal perforation infection, causing abscess after rectal space. 4 Local anesthesia infection, or poor absorption after injection of oil solution, and form an abscess.
Postoperative factors (15%):
Clinically, an anorectal infection can also be seen, and the formation of peri-abdominal abscess, as well as urethral infection, perineal infection, postpartum perineal rupture and suture infection, postoperative infection of sacral osteomyelitis and other abscesses.
Infectious factors (30%):
Modern medicine believes that infection is the main cause of this disease.
Other factors (13%):
Infection after infection of foreign bodies in the rectum, actinomycosis, infection of rectal diverticulitis, ulceration of anorectal cancer or deep infection, and weakness, low immunity, or chronic wasting disease, or malnutrition It is the cause of the anorectal abscess.
Prevention
Perianal abscess prevention
Perianal abscess prevention and health care
1. Actively exercise, enhance physical fitness, improve blood circulation, strengthen local disease resistance, and prevent infection.
2. Keep the anus clean, change the underwear frequently, and clean the anus afterwards, which has a positive effect on preventing infection.
3. Actively prevent other anal diseases, such as anal cryptitis and anal papillitis, to avoid perianal abscess and anal fistula.
4. If not treated in time, it may cause other diseases such as ulcerative colitis and intestinal tuberculosis with clinical manifestations of perianal abscess.
5. Avoid sedentary wetlands, so as to avoid the cold and wet parts of the anus, causing infection.
6. Prevention and treatment of constipation and diarrhea is important for the prevention of perianal abscess and anal fistula formation.
7. Once an anorectal abscess occurs, it should be treated early to prevent its spread and spread.
8. Active prevention and treatment of other anorectal diseases, such as anal sinusitis, anal papillary hypertrophy, anal fissure, inflammatory fistula, proctitis, etc., can promptly, correctly and effectively treat, can avoid and reduce the occurrence of perianal infection, abscess and anal fistula.
Complication
Perianal abscess complications Complications anal fistula sciatic rectal abscess
1. Low anal fistula.
2. The ischial rectal abscess.
Symptom
Perianal abscess symptoms Common symptoms Anal skin with eczema Anal skin flushing Anal itching Anal endocrine more connective tissue external purulent discharge Anal perineal area Moisture anal abscess Anal night itching
Subcutaneous abscess around the anus is most common, mostly caused by anal gland infection through the lower part of the external sphincter skin outward or directly outward, often located in the lower part of the skin around the anus, generally not large, the main symptoms are persistent perianal severe pain, pressure Or increased cough, inconvenient walking, restlessness, systemic infection symptoms are not obvious, local examination: the skin around the anus is obviously red and swollen, with induration and tenderness, may have a sense of volatility, if necessary, puncture confirmed, if not cut in time It often breaks down on its own and forms a low anal fistula. The infection can also penetrate the perianal fascia upwards and spread to the ischial rectal fossa. Sometimes it is misdiagnosed as a thrombotic external hemorrhoid in the early stage, but the latter has a clear boundary and no inflammatory reaction around the skin.
Examine
Examination of perianal abscess
1. B super measurable and abscess.
2. Increased white blood cell and neutrophil counts.
3. There are indurations or lumps around the anus, local temperature increases, tenderness or fluctuations. An abscess located above the levator ani muscle, a rectal examination can touch a tender mass, and a pus can be drawn from the rectal puncture.
Diagnosis
Diagnosis and diagnosis of perianal abscess
Clinical patients have small hard masses or masses around the anus, and then the pain is aggravated, redness and fever, bulging discomfort, restlessness, no sleep at night, constipation, poor urination, and urgency. And followed by systemic symptoms such as general malaise, mental fatigue, increased body temperature, loss of appetite, chills and high fever. Generally, an abscess can be formed in about 1 week, and a soft, tender, and fluctuating mass can be felt in the rectum around the anus, and the pus can be extracted by puncture with a syringe. It can be diagnosed based on the combined laboratory examination data.
Differential diagnosis
Mainly differentiated from perianal skin infections.
