Acute Paraproctitis. Review of the Literature

Abstract


Acute anal abscess remains the issue of the day of modern surgery, which is due to, in particular, its occurrence in 0.5% of the population, 0.5-4% of surgical and 10-50% of coloproctological patients. In the article, the analysis of the literature on the etiology, classification, clinical picture, diagnosis and treatment of acute anal abscess is performed. The review revealed that 98% of acute anal abscess is caused by mixed microflora - staphylococci, streptococci in combination with E. coli. The clinical picture of acute anal abscess depends on the localization of inflammation, the virulence of microflora and the immunoreactivity of the organism. Diagnostic methods of acute anal abscess are finger and bidigital rectal examination, anoscopy, rectal examination with a mirror and rectoromanoscopy. Endorectal electrical thermometry, ultrasonography, abscessography, chromoabscessography, computed tomography, magnetic resonance imaging and others can be used as well. Once the diagnosis of acute anal abscess is established, urgent surgical intervention must be performed, which consists of the incision and drainage of abscess with the possible elimination of the opening in the zone of the anal crypt. The postoperative management of patients with acute anal abscess may involve the use of ultrasound, laser, phototherapy, oxygen and ozone therapy, wound dialysis, hydrophonophoresis, multicomponent drugs and others. Thus, as the data in the literature reveals, many questions concerning the management of patients with acute anal abscess are not resolved to the full extent. This is evidenced by the development of inflammatory complications in 13-20%, relapses in 1.5-40%, anal sphincter deficiency in 1.5-27.9% of cases, which makes it worthwhile to continue research on developing new methods of treatments for acute anal abscess

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com

N.N. Burdenko Voronezh State Medical Academy, 10 Studencheskaia Str., Voronezh, 394036, Russian Federation

Email: author@vestnik-surgery.com

  • Abdullaev M.Sh., Mansurova A.B. Ostryy paraproktit u bol'nykh
  • s sakharnym diabetom (obzor literatury) [Acute paraproctitis in patients
  • with diabetes mellitus (review of literature)]. // Coloproctology.
  • ; 1: 46-51. (in Russ.).
  • Abramov E.K., Morozov Iu.I., Markov A.M. Problemy proktologii: tezisy dokladov. [Proc. Conf.
  • "Problems of proctology"]. // Moscow. 1981; 107. (in Russ.).
  • Akopian E.B. Mestnye vospalitel'nye posleoperatsionnye
  • oslozhneniia paraproktitov. Diagnostika, lechenie i profilaktika
  • [Local inflammatory postoperative complications of paraproctitis.
  • Diagnosis, treatment and prevention. Cand. Diss. Med. Sci.]. //
  • Tbilisi. 1981; 18. (in Russ.).
  • An V.K., Rivkin V.L. Aktual'nye problemy
  • koloproktologii: Materialy pervogo s"ezda koloproktologov
  • Rossii s mezhdunarodnym uchastiem [Proc. 1st Cong. "Actual
  • problems of Coloproctology"]. // Samara. 2003; 21-22. (in Russ.).
  • Balaitis Iu.V., Poida A.I., Zhel'man V.A. [Features of development
  • and generalization of infection in acute paraproctitis]. Pervyi
  • Belorusskii mezhdunarodnyi kongress khirurgov. Sbornik
  • nauchnykh trudov [Proc. 1st Int. Cong. Surg.]. // Vitebsk. 1996;
  • -167. (in Russ.).
  • Borodinets A.L., Ageev V.P., Kremen' V.E. [Results of treatment
  • of acute paraproctitis]. Pervyi Belorusskii mezhdunarodnyi
  • kongress khirurgov [Proc. 1st Int. Cong. Surg.]. // Vitebsk. 1996;
  • -159. (in Russ.).
  • Borodinets A.L., Rusinovich V.M., Kirkovskii V.V. Problemy
  • koloproktologii. Sbornik nauchnykh trudov GNTs koloproktologii
  • [Proc. GSC's of coloproctology "Problems of Coloproctology"]. //
  • Moscow. 1998; 16: 31-36. (in Russ.).
  • Vorob'ev G.I. Osnovy koloproktologii [Basics of Coloproctology]. //
  • Moscow: Meditsinskoe informatsionnoe agentstvo, 2006; 432.
  • (in Russ.).
  • Vorob'ev G.I., Nikitin A.M., Rivkin V.L. Obsledovanie
  • proktologicheskogo bol'nogo [The survey of proctological
  • patient]. // Moscow, 1993; 28. (in Russ.).
  • Goshchitskii L.G., Mozel' Iu.L., Mikhlin B.A. Sbornik "Problemy
  • proktologii" [Digest "Problems of Coloproctology"], // Moscow.
  • ; 14: 15–18. (in Russ.).
  • Grigor'ev E.G., Shcherbatykh A. V. Klinicheskie lektsii po
  • khirurgii. Chast' 2. Izdanie 4-e, pererabotannoe i dopolnennoe.
  • [Clinical lectures on surgery]. // Irkutsk, Irkutskii gosudarstvennyi
  • meditsinskii universitet. 2009; 220. (in Russ.).
  • Dul'tsev Iu.V., Salamov K.N. Paraproktit [Paraproctitis]. //
  • Meditsina. 1981; 206. (in Russ.).
  • Zhakipbaev K.A., Makishev A.K., Mun N.V.
  • Problemy koloproktologii: Sbornik nauchnykh trudov GNTs
  • koloproktologii [Proc. of the GSC of coloproctology "Problems
  • of Coloproctology"]. // Moscow. 1998; 16: 46-49. (in Russ.).
  • Zaremba A.A. Klinicheskaia proktologiia [Clinical proctology]. //
  • Riga: «Zvaigzne» Publ., 1987; 359. (in Russ.).
  • Ishimov M.S., Khidiiatov I.I., Amirova D.Kh. [The possibility of
  • using computed tomography in the diagnosis of deep forms of
  • acute paraproctitis]. 3-ia Vserossiiskaia nauchno-prakticheskaia
  • konferentsiia «Novye tekhnologii v khirurgii» [3rd Conf "New
  • Technologies in Surgery"]. // Ufa. 129-130. (in Russ.).
  • Kogan A.I. Materialy k patogenezu, klinike i terapii
  • priamokishechnykh svishchei [Materials to a pathogenesis,
  • clinic and therapy of rectal fistulas. Doct. Diss. Med. Sci.]. //
  • Dnepropetrovsk. 1957; 31. (in Russ.).
  • Mal'tsev V.N., Korolenko V.B. Vrachebnaia taktika pri ostrom
  • paraproktite. Problemy reabilitatsii proktologicheskikh bol'nykh
  • [Medical tactics to the patient with acute paraproctitis. Problems
  • of rehabilitation of patients with proctologic pathology]. // Minsk.
  • ; 19-20. (in Russ.).
  • Masliak V.M., Stasyshin R.I. Aktual'nye problemy
  • koloproktologii: Materialy konferentsii [Proc. of Conf. "Actual
  • Problems of Coloproctology"]. // Nizhnii Novgorod. 1995; 272-
  • (in Russ.).
  • Naumov A.I., Maskin S.S., Gevorkov A.R. Endolymphatic
  • therapy of the acute purulent paraproctitis. Aktual'nye problemy
  • koloproktologii: Materialy konferentsii [Proc. of Conf. "Actual
  • Problems of Coloproctology"] //. 1999; 94. (in Russ.).
  • Oleinikov P.N., Baranov O.N., Nosov V.A. Sbornik tezisov 3 Vserossiiskoi nauchno -
  • prakticheskoi konferentsii «Novye tekhnologii v khirurgii» [Proc.
  • of Conf. "New Technologies in Surgery"]. // Ufa. 1998; 140-142.
  • (in Russ.).
  • Oleinikov P.N., Baranov O.N., Nosov V.A., Klimanov A.V. Ul'trafioletovoye oblucheniye krovi v kompleksnom lechenii
  • bol'nykh s ostrym paraproktitom
  • [Ultraviolet irradiation of blood in the complex treatment of
  • patients with acute paraproctitis]. // Proc. of Conf. "New Technologies in Surgery". Ufa. 1998; 142-144
  • Rivkin V.L., Bronshtein A.C., Fain S.N. Rukovodstvo po
  • koloproktologii [Guidance of Coloproctology]. // Moscow, 2001;
  • (in Russ.).
  • Semionkin E.I. Koloproktologiia (Uchebnoe posobie)
  • [Coloproctology (Tutorial)] // Moscow: ID MEDPRAKTIKA
  • Publ., 2004; 234. (in Russ.).
  • Seropian G.A., Bichev R.P.,Dezortsev I.L. Aktual'nye problemy
  • koloproktologii [Proc. of Conf. "Actual Problems of
  • Coloproctology"]. // Irkutsk, 1999; pp. 120-121. (in Russ.).
  • Suvorova G.N. Osobennosti gistogeneza i regeneratsii priamoi
  • kishki i ee sfinkternogo apparata. [Features of histogenesis and
  • regeneration of the rectum and sphincter apparatus. Doct. Diss.
  • Med. Sci.]. // Saransk. 2001; 42. (in Russ.).
  • Sufiiarov R.S., Nurtdinov M.A., Gabidullin Z.G.,
  • Gabdrakhmanova A.A. Lecheniye paraproktita, vyzvannoye
  • assotsiatsii Sankt-Aureus s pr. Vulgaris, Morganellamorganii i
  • Enterobacter aggl [Treatment of paraproctitis caused by
  • associations St. Aureus with pr. Vulgaris, Morganellamorganii and
  • Enterobacter aggl.] // Vestnik Iuzhno-Ural'skogo gosudarstvennogo
  • universiteta. Seriia: Obrazovanie, zdravookhranenie, fizicheskaia
  • kul'tura, 2012; 8 (267): 70-73. (in Russ.).
  • Timerbulatov V.M., Kalanov R.G., Ishimov M.S Paraproktit
  • [Paraproctitis]. // Ufa, 1998; 205. (in Russ.).
  • Fedorov V.D., Vorob'ev G.I., Rivkin V.L. Klinicheskaia
  • operativnaia koloproktologiia [Clinical operative proctology]. //
  • Moscow, 1994; 450. (in Russ.).
  • Fedorov V.D., Dul'tsev Iu.V. Proktologiia [Proctology]. // Moscow:
  • Meditsina Publ., 1984; 384. (in Russ.).
  • Khrenov V.E., Stygin O.V., Zvol'skaia E.Iu.
  • Materialy konferentsii "Aktual'nye problemy koloproktologii"
  • [Proc. of Conf. "Actual Problems of Coloproctology"]. // Nizhnii
  • Novgorod. 1995; 304. (in Russ.).
  • Shelygin Iu.A., Blagodarnyi L.A. Spravochnik po koloproktologii
  • [Handbook of Coloproctology]. // Moscow: Litterra, 2012; 596. (in
  • Russ.).
  • Ektov V.N., Nalivkin A.I. Aktual'nye problemy koloproktologii:
  • Tezisy dokladov [Abstracts of Conf. "Actual Problems of
  • Coloproctology"]. // Rostov-na-Donu. 2001; 88. (in Russ.).
  • Nelson R. Anorektal'naya abstsess svishcha: chto my znayem? [Anorectal abscess fistula: what do we know?] // Surg
  • Clin. North Am. 2002; 82(6): 1139–1151.
  • Sahni VA, Ahmad R, Burling D. Kakoy metod luchshe vsego podkhodit dlya
  • vizualizatsiya perianal'noy fistuly? [Which method is best for
  • imaging of perianal fistula?] // Abdom Imaging, 2008; 33: 26: 30.
  • Senagore A.J. Intrarektal'noye i vnutri anal'noye ul'trazvukovoye issledovaniye votsenke kolorektal'nogo patologii [Intrarectal and intra-anal ultrasonography in the
  • evaluation of colorectal pathology.] // Surg. Clin. North. Am. 1994;
  • : 6: 1465-1473;
  • Stoker J. at al. Endolyuminal'naya MRT pryamoy kishki i zadnego prokhoda:
  • tekhnika, prilozheniya i podvodnyye kamni [Endoluminal MR imaging of the rectum and anus:
  • technique, applications, and pitfalls.] // Radiographics. 1999; 19: 2:
  • -398.
  • Ustynoski K., Rosen L., Stasik J. et al. Podkova abstsess svishcha:
  • Seton lecheniye. [Horseshoe abscess fistula:
  • seton treatment.] // Dis. Colon Rectum. 1990; 33: 7: 602-605.
  • Van Outryve M. Endoskopicheskoye ul'trazvukovoye issledovaniye v vospalitel'nom
  • zabolevaniya kishechnika, paracolorectal vospalitel'noy patologii, i
  • zaochnaya anomalii [Endoscopic ultrasonography in inflammatory
  • bowel disease, paracolorectal inflammatory pathology, and
  • extramural abnormalities.] // Gastrointest. Endosc. Clin. N. Am.
  • ; 5: 4: 861-867.
  • Van de Stadt J. Svishch v ANO: mesto rektal'nogo prodvizheniya loskut
  • tekhnika. [Fistula in ano: the place of rectal advancement flap
  • technique.] // Acta. Chir. Belg. 2000; 100: 3: 123-127.
  • Van Tets W.F., Kuijpers H.C. Seton lecheniye perianal'nykh svishchey
  • s vysokoy anal'nom ili rektal'nogo otkrytiya [Seton treatment of perianal fistula
  • with high anal or rectal opening.] // Br. J. Surg. 1995; 82: 895-897.
  • Veronikis D.K., Nichols D.H., Spino C. Nobl-MengertFish
  • operatsiya-Revisited: kompozitsionnyy podkhod k stoykim
  • rektovaginal'noy svishchi i slozhnyye defekty promezhnosti [The Noble-MengertFish
  • operation-revisited: a composite approach for persistent
  • rectovaginal fistulas and complex perineal defects.] // Am. J. Obstet.
  • Gynecol. 1998; 179: 1411–1416.
  • Wedell J., Meier zu P. Eissen et al. Razdvizhnaya zakrylkov dlya uluchsheniya
  • [Lecheniye vysokogo urovnya svishchey Sliding flap advancement for
  • treatment of high level fistulae.] // Br. J. Surg. 1987; 74: 390-391.
  • Whiteford M.H., Kilkenny J., Hyman N. et al. parametry praktiki
  • dlya lecheniya peri abstsessov i svishchey-v-ANO (v novoy redaktsii). [Practice parameters
  • for the treatment of peri abscess and fistula-in-ano (revised).] // Dis.
  • Colon Rectum. 2005; 48: 1337-1342.
  • Zimmerman D.D., Delemarre J.B., Gosselink M.P., Hop
  • W.C. et al. Kureniye vliyayet na iskhod transanal'noy slizistykh obolochek
  • prodvizheniye loskut remont transsphincteric svishchey [Smoking affects the outcome of transanal mucosal
  • advancement flap repair of transsphincteric fistulas.] // Br. J.
  • Surg. 2003; 90: 3: 351-354.
  • Zmora O., Mizrahi N., Rotholtz N. et al. Fibrinovyy kley zapechatyvaniya
  • pri lechenii perianal'nykh svishchey. [Fibrin glue sealing
  • in the treatment of perineal fistulas.] Dis. Colon Rectum.
  • ; 46: 5: 584-589.

Views

Abstract - 115

PDF (Russian) - 157


Copyright (c) 2013 ., .

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.