Acute paraproctitis

Acute paraproctitis is an acute inflammation within the rectal tissue, caused by the spread of the inflammatory process from the anal crypts and anal glands.

The reasons

The causative agent of infection in paraproctitis in the bulk of cases is a mixed microflora. Most often, staphylococci and streptococci are found in combination with Escherichia coli, Proteus. Not often (especially in the abscesses of the pelviorectal space) the presence of bacteroids, peptococci, fusobacteria, belonging to non-spore-forming anaerobes, is detected. Acute paraproctitis, caused by mixed microflora, is traditionally called simple, banal.


The disease usually begins acutely. Following a short prodromal period with malaise, weakness, headache, there is increasing pain in the rectum, perineum, or pelvis, accompanied by fever and chills.

The severity of the symptoms of acute paraproctitis depends on the location of the inflammatory process, its prevalence, the nature of the pathogen, and the reactivity of the body. With the localization of the abscess in the subcutaneous tissue, the clinical manifestations are more pronounced and definite: a painful infiltrate in the anus, skin flushing, an increase in body temperature, as a rule, force you to consult a doctor in the first days after the onset of the disease.


The first and main task of diagnosing acute paraproctitis is to recognize the presence and localization of the abscess in the cellular space surrounding the rectum based on the patient’s complaints, clinic and examination.


Treatment of acute paraproctitis is only surgical. The operation must be performed immediately after the diagnosis is established, since it belongs to the category of urgent. The type of anesthesia plays an important role. Complete anesthesia and good relaxation are required. The most commonly used intravenous anesthesia, epidural and sacral anesthesia, mask anesthesia.

Local anesthesia in operations for acute paraproctitis is impractical due to the risk of spreading infection during an anesthetic injection, inadequate anesthesia and complicating orientation due to tissue infiltration with an anesthetic solution.

The main tasks of a radical operation are the obligatory opening of the abscess, draining it, searching for and finding the affected crypt and purulent tract, eliminating the crypt and tract. If you eliminate the connection with the intestine, you can count on the complete recovery of the patient.

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