True paraproatitis is the inflammation of the paragreotal fiber, which develops as a result of the penetration of infection from the near-blur region in the lumen of the rectum. Chronic paraprojectite is an complication of acute paraproctitis.
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Concept of true paraprokt
True paraproatitis is not the usual fitting of the paragreotal fiber, not a banal, as, for example, a furuncle or abscess, arising from the infection of the perianal region outside, and inflammation in which the infection penetrates into the tissue of the octurocycle area from the lumen of the rectum, precisely, from the mouth of the anal glands on the day of the posteripal (morganevy) crypt.
One of the deepest morganeic crypt is primarily inflated, T.To. Cryptogranduarny abscess, which often spontaneously reveals outside or in the intestinal lumen. In other cases (most often), such an abscess is opened by surgical pathway and after this, it would seem, a radical operation remains fistula, or abscess recurrences.
The causes of infection and inflammation of these glands are much, in particular, it is a hemorrhoids and a chronic anal crack, although young and practically healthy people have anal glands can be inflamed without any, at first glance, reasons. But it is at first glance. With a directional polling of such patients, as a rule, small uncomfortable phenomena are revealed, such as periodic anal itching, moisturizing perianal leather, unwitting pains during and after chairs, constipation or diarrhea.
In general, the inflammation of the anal glands and, accordingly, the morganeic crypt is the root cause of paraproatitis, and therefore the simple opening of the ventilation outside, without the sanitation of the inflamed area of the anal channel (the inner hole of the abscess), does not lead to a resistant recovery.
Affected anal crypt (or several neighboring crypt), t.E. The inner hole of the abscess is easily achieved with a finger and is determined in the form of a painful point with the release of pus drops or (if the abscess has not yet revealed) in the form of swelling with all classical signs of inflammation. If the inner hole of the abscess or fistula is located above, then it is not about banal, nonspecific inflammation, but about injuries of the intestine or internal fiction. Such a state occurs during Crohn's disease, with ulcerative colitis, or very rare pathology - the fistulaous form of intestinal tuberculosis. If the inner opening is not determined, then the suppuration of the paragreotal fiber is the most correct due to inflammation «outside» - furuncle, carbuncoon, phlegmon, actinomycosis, venereal lymphoganoal (Nikola-Pava disease) and t.NS.
Features of chronic paraprojectite
With spontaneous opening of acute paraproatitis or with a palliative operation of a simple, even widespread, drainage of a peppy The inner hole of the abscess in the anal channel remains. It, as a rule, does not heal and remains stubbornly, the current fistula or, much less often, heals the fragile scar and when repetition of any adverse circumstances - constipation, injury when driving on a motorcycle, bicycle and t.NS. - The inflammation in the same place of the anal channel appears, and the abscess is repeated, and its localization on the crotch can be different, t.E. The inner opening with this course of the disease (acutely recurrent paraprojectite) is almost always the same, and the suppuration of soft tissues on the perineum can be localized both in the zone of the old scar and elsewhere, even on the opposite side.
With this variant of the flow of paraproatitis between exacerbations, there is practically recovery. Tactics for the treatment of such recurrent octurists does not differ from such a primary acute parapet.
Much more often, the wound on the perineum after a simple opening of the jet does not heal and remains straightforward fistula. The infection is maintained by constant infection of the inner opening of the fistula of the high-voluminous pathogenic flora of the rectum.
