Ultrasonography or Perirectal Abscess

General or Other | Gastroenterology | Ultrasonography or Perirectal Abscess (Disease)


Description

Perianal abscesses are defined as collections of pus around the anus (perianal tissue) which commonly begins as cryptic. In the anal canal there is a plain line formed 10 to 15 recesses (pockets) that open cranial adjacent papillae lined (self-called teeth). If one of these recesses is inflamed, the condition is called cryptic.

Abscess often appears as a swelling (a lump) in the red skin from around the anus. Some perianal abscesses can remove pus and heal spontaneously, while others require surgery. Perianal abscess is more superficial location. Perirectal abscess is a localized collection of pus, the deeper tissues of interest around the anus (the collection is formed around the rectum).

Causes and Risk factors

Perirectal abscesses occur three times more common in men than in woman. Perirectal abscesses and perianal begins as an infection in the crypts of Morgagni where the anal glands (encrypted). Infection (and therefore pus) may develop and may extend deep into the spaces around the anus and rectum.

If not evacuated, purulent collection grows and major symptoms associated pain, fever and even major bowel disorders. Inflammatory process that leads to abscess may be due to rupture or of infringement of the lining of the anal canal, rectum or skin around the anus and subsequent infection with Escherichia coli, staphylococci, streptococci, bacillus Koch, etc. Such injuries may occur during treatment of internal hemorrhoids, enemas, eliminating eggshells or fish bones or introducing objects ingested. Systemic diseases that can cause abscesses include ulcerative colitis and Crohns disease. Other causes include malignancy, radiation, infectious dermatitis . In some people there is a greater risk of developing abscesses and perianal abscesses.

The main risk factors are: Diabetes mellitus interferes with the immune system so the body is more prone to infections than healthy individuals; Chronic Constipation; AIDS (HIV infection), especially when the number of white blood cells is very low; Crohns disease or other chronic inflammatory bowel disease; People who use drugs that suppress the immune system like steroids (prednisone, methylprednisolone), or chemotherapy for cancer; Pregnancy; People who practice anal sex.

Diagnosis and Treatment

Recognition of a perirectal abscess is the primary emergency department (ED) goal. Determination of the exact anatomic space or spaces involved is best left to the surgical consultant.

The isolated perianal abscess that is not associated with deeper, perirectal abscesses is the only type of anorectal abscess that can be adequately treated in an ED setting and is very rare.

Perirectal abscess must be treated in the operating suite, where optimal anesthesia can be achieved and the abscess and any fistula or other complication may be treated definitively. The point of a deep abscess must not ...