A perianal abscess is an acute purulent infection that occurs around the anorectal tract, and its source of infection is at the junction of the canal and rectum in the anus, which is a tissue called the sinus, and the infection bacteria are mainly E. coli in the feces. This disease is different from infections in other parts of the body, and its peculiarity is that once it occurs, there is basically no possibility of self-healing and drug cure.
The full name of fistula should be anorectal fistula, which we usually call fistula, which is also called leakage in Chinese medicine. Literally, a fistula is a pipe formed by the outward rupture of the body due to the occurrence of lesions. fistula is a tube formed after the soft tissue around the anorectum is infected with suppuration or artificially cut, and this tube begins as one, and as the disease progresses, there can be more than one. The inner mouth of the tube is the entrance to the infection, and the outer mouth of the tube is a rupture or surgical incision, mostly outside the anus, but also in the anus and rectal wall.
Causes: Although infections are frequent around the anus, there are triggers, what is the cause of the onset of perianal abscesses, through the history of some patients and the revelations received from leukemia, Crohn's disease, tuberculosis, diabetes prone to this disease, physical fatigue or weakness, decreased resistance and diet are the main causes of local infections. Many patients complain of irregular life before the onset of illness, lack of sleep, overwork, or excessive alcohol consumption, or excessive consumption of seafood, spicy, and meat.
In the perianal area there is a tissue called gland, the gland is located in the sphincter, its opening is in the sinus on the line of the teeth in the anus, usually the secretion of the gland through the opening at the anus sinus into the rectal cavity, has a lubricating effect on the intestine. The opening of the sinus is up, like the pocket of human clothing, the fluid and feces of the intestinal cavity are easily retained here, when the fecal infection enters the sinus can cause sinusitis, inflammation can spread along the gland mouth, the glandular canal to the gland, and finally through the lymphatic vessel into the space around the anorectal tract, causing soft tissue infection and suppuration to form the disease.
fistula is a sequelae of an anorectal abscess, periorectal abscess rupture or incision is often outside the anus, pus flows out of the external mouth, but the primary infection is mostly in the sinus. The sinus is the gateway to continued infection, because the sinus opens upwards and opens up in the rectal cavity, and both bacteria and intestinal contents can enter the pus cavity through the sinus, causing repeated infections and forming fistulas.
Symptoms: The main symptom of perianal abscess is pain in the anus, which is persistent and has nothing to do with stool, restlessness when the pain is severe, loss of appetite, and some patients will find a lump around the anus, or accompanied by symptoms such as difficulty defecation. With this disease, there are many fevers of varying degrees, the degree of leukocyte elevation, fever and leukocyte elevation marks the depth and size of the abscess.
fistula is accompanied by a history of different degrees of paraanal swelling and pain ulceration and pus, after the formation of fistula, this paraanal swelling pain and pus will be repeated from time to time, if the pus does not flow smoothly, local and generally will show the symptoms of acute purulent infection, such as local redness, swelling and heat pain of the anus, increased body temperature, etc., but with the re-ulceration and outflow of pus, these symptoms will gradually alleviate. If the fistula does not heal for a long time, it will also cause difficulty defecation, anemia, physical wasting, mental atrophy, neurasthenia and so on.
Treatment: Once a perianal abscess occurs, there is no possibility of self-healing and drug cure, and only surgery can cure it. Timely treatment after perianal abscess can prevent the infection from spreading throughout the body and endanger life; second, it can prevent the infection from spreading to the surrounding areas, resulting in a horseshoe abscess and then forming a complex fistula; the third can prevent the abscess from rupturing into an fistula; the fourth can alleviate pain; the fifth can prevent the sphincter from being damaged and affecting function. Surgical treatment of perianal abscesses is aimed at thoroughly cutting the pus cavity and the inner opening of the source of infection, causing the pus to flow out, the pus cavity wall to fall off, and then filling the abscess cavity through granulation growth, and finally healing the abscess. During the operation, attention should be paid to determining that the inner orifice should be accurate, the incision should be sufficient, no dead cavity should be left, and the drainage should be smooth.
fistula, like paraanal abscesses, differs from infections in other parts of the body, and because it occurs near the anorectum, there is a fixed source of infection in the anus or rectal cavity, that is, the internal opening, and the lesion is located in the sphincter, and the relaxation and contraction of the sphincter can affect the discharge of pus. Therefore, once fistula and paraanal abscess occur, no matter how serious it is, there is no possibility of self-healing, and drug treatment will only alleviate symptoms, and clinical treatment can only be achieved through surgery (including hanging threads). Many attempts have been made in the past to treat them with multiple methods other than surgery, but all have failed, and so far no non-surgical methods have been found to cure fistulas and perianal abscesses. The purpose of fistula surgery is to cut open the fistula, remove the inner opening, completely eliminate the source of infection, drain the fistula smoothly, allow the newborn granulation tissue to grow from the bottom of the wound upwards, and gradually fill the wound.
Prevention: Although infection and suppuration are prone to occur around the anorectum, it can be prevented if we pay attention to it in normal times. The method of prevention is summarized by the 12-word policy, which is: "living and living regularly, eating and drinking moderately, combining work and leisure." Living often requires us to live a regular life, including developing a daily regular bowel movement, which helps to maintain a certain resistance of the body and keep the stool normal. Diet requires less fat, sweet, spicy and spicy products to avoid overeating. The combination of work and leisure requires us to move appropriately, especially not to overtidinate.
Prognosis: In the past, it was thought that fistula is a chronic inflammatory disease, generally not cancerous, but in recent years, there have been reported cases of fistula cancer, such as statistics from 90 to 98 years in China a total of 6 cases reported, the author has also encountered 2 such patients in the clinic, which should arouse our great attention. Summarizing these cancerous cases, there are generally the following characteristics: (1) the history of fistula is more than 10 years; (2) there are many secretions, odorous, and sometimes mucin-like; (3) the local tissues of the anus are hard and the pain is obvious. The cause of fistula cancer is not very clear at present, but it is generally believed that the lymphatic structure in this area is destroyed, and the immune monitoring ability to inhibit interstitial or malignant changes is reduced. The fundamental way to prevent fistula cancer is to treat fistula in a timely manner.