Anorektalabszess

Under a Anorektalabszess refers to a local collection of pus in the perirectal areas. Abscesses usually develop from a Analkrypte. The symptoms are pain and swelling. The diagnosis is made primarily by examination and CT or deeper abscesses by an MRI of the pelvis. The treatment consists in an operative drainage.

(See also Clarification of Anorektalkrankheiten.)

Under a Anorektalabszess refers to a local collection of pus in the perirectal areas. Abscesses usually develop from a Analkrypte. The symptoms are pain and swelling. The diagnosis is made primarily by examination and CT or deeper abscesses by an MRI of the pelvis. The treatment consists in an operative drainage. (See also Clarification of Anorektalkrankheiten.) An abscess can in the different rooms that surround the rectum, localized and be superficial or deep. A Perianalabszess is superficial and visible on the skin. A Ischiorektalabszess is lower and spreads over the sphincter in the Ischiorektalraum under the levator ani muscle in. He can penetrate to the contralateral side and form a so-called. Hufeisenabszess. An abscess above the levator ani muscle (z. B. Supralevatorabszess) is very deep and can spread to the peritoneum or abdominal organs. This abscess is often created on the ground of diverticulitis or inflammation in the pelvis. Sometimes the Crohn’s disease causes (v. A. Of the colon) anorectal abscesses. Usually a mixed infection occurs with Escherichia coli, Proteus vulgaris, Bacteroides, streptococcus and staphylococcus. Symptoms and complaints Superficial abscesses can be very painful perianal swelling, redness and tenderness are characteristic. Fever rarely occurs. Deeper abscesses are less painful, but can cause toxic symptoms (eg. As fever, chills and malaise). Perianal you often see negative results, but the digital rectal examination results in a painful pressure fluctuating swelling of the rectal wall. High pelvirektale abscesses can cause lower abdominal pain and fever without rectal symptoms. Sometimes fever is the only symptom. Diagnosis Clinical evaluation Sometimes investigation rarely under anesthesia or CT in patients who have an abscess, a normal digital rectal examination and no signs of systemic disease, imaging is not required. CT scan is useful when a deep ulcer or Crohn’s disease are suspected. Higher Supralevatorabszesse require a CT to determine the intra-abdominal infection sources. In patients with suspected a deeper abscess or a complex perianal Crohn’s disease, a check should be done under anesthesia at the time of drainage. Therapy incision and drainage antibiotics in high risk patients are necessary immediate incision and adequate drainage, they should not be so long in coming, until the abscess to the outside is visible. Many abscesses can be drained on an outpatient basis, deeper abscess may require drainage system in the operating room. Patients with fever, neutropenia or diabetes or those with significant cellulitis should also receive antibiotics (eg. As ciprofloxacin 500 mg iv every 12 h and metronidazole 500 mg iv every 8 h, ampicillin / sulbactam 1.5 g iv every 8 h). For healthy patients with superficial abscesses contrast, antibiotics are not indicated. After the drainage anorectal fistula can occur. Summary anorectal abscesses may be superficial or deep. Superficial abscesses are diagnosed clinically and outpatient or drained in the emergency room. Deep abscesses often require imaging with CT and must be drained normally in the operating room. Immunocompromised patients and those with deep abscesses should receive antibiotics.

Health Life Media Team

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