Chronic paraproctitis - a chronic inflammation that affects the anal crypt, mezhsfinkternoe space and paraproctium. The result is a adrectal fistula.
Fistula - a pathological channel that connects the seat of the disease (most commonly an abscess or tumor) with the surface of the body or any of its cavity. In addition, a fistula may form between two hollow organs. At the same time, internal fistula is a hole adrectal anal crypt.
Adrectal fistula is always considered to be a consequence of acute myocardial paraproctitis. Almost one in three patients with acute paraproctitis seek medical help after an abscess was discovered spontaneously. Such a spontaneous dissection paraproctitis and leads to adrectal fistula. Even some of the patients with acute paraproctitis go to the doctor when after opening the abscess has already formed a fistula.
Patients with the same time that have come to the doctor to reveal an abscess in acute paraproctitis can not always get the radical surgical treatment. The main thing to do at the opening of an acute paraproctitis - is the elimination of the entrance gate of infection. Usually, your doctor may reveal an abscess, the pus removed, rinse the cavity and install drainage, but if the very source of infection is not eradicated, it leads to a permanent infection of the intestinal lumen.
As a result of constant "recharge" the course of a purulent inflammation of the walls of the surrounding connective tissue - so there fistulous course. External opening of fistula adrectal usually can be opened in the perineum.
The size of the external opening of the fistula is usually not more than 1 mm. In addition, in the course of the fistula in adrectal paraproctium may have become numb and purulent infiltration (compaction), if the cavity is not very well-drained (ie, a bad set for the outflow of pus).
Manifestations of chronic paraproctitis
Chronic abscess - a consequence of acute paraproctitis. So many of the symptoms are similar, except that in chronic paraproctitis their intensity is much smaller. The main complaint of the patient with a fistula adrectal selection in the perineal region. This separation, or have pus sukrovichny character. If such allocation is sufficient plentiful, they can cause skin irritation and itching.
If the fistula is a well-drained adrectal, that is, pus is free, the pain usually does not bother the patient. Most often the pain happens when an incomplete internal fistula. Pain is usually worse during defecation, and then subsides as tensile anal canal at the time of passage of stool incomplete internal fistula is better drained.
During adrectal fistula usually occurs in waves - which means that during the acute process subsided relative can come exacerbation of inflammation. This is due to occlusion is usually fistulous purulent-necrotic masses. There is an abscess, and after opening and emptying of its acute process subsides, the pain disappears, the general condition of the patient improves.
But the wound did not heal completely, it continues to go from the purulent discharge. If you have bloody discharge, the doctor should be alert to cancer.
During the period of remission, the pain is not characteristic of direct adrectal fistula. Typically, patients at this time feel quite satisfactory. If this patient carefully complies with all hygienic measures, the period of remission lasts a long time.
In the same period of exacerbation of the patient's fistula, pain, increased pus. All this is reflected accordingly in his general condition. There are asthenia, headache, insomnia, suffer from the psyche.
Complications adrectal fistula
Complex adrectal fistulas, especially with infiltrates and purulent streaks, with frequent exacerbations, may cause significant deterioration of the patient.
Long duration of the inflammatory process leads, in turn, to a significant deformation of the anal canal and perineum. Cicatricial changes occur in the anal sphincter, which leads to its failure.
For hronicheskogo paraproctitis characteristic of a complication that occurs in patients with chronic anal fissure, as pektenoz. It scars in the wall of the anal canal. Their result - a reduction in the elasticity of the anal canal and its scar stricture.
Long-term course of chronic paraproctitis (over 5 years) can sometimes lead to cancerous degeneration of the fistula.