Acute Paraproctitis. Review of the Literature


Cite item

Full Text

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

About the authors

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

References

  1. Abdullaev M.Sh., Mansurova A.B. Ostryy paraproktit u bol'nykh
  2. s sakharnym diabetom (obzor literatury) [Acute paraproctitis in patients
  3. with diabetes mellitus (review of literature)]. // Coloproctology.
  4. ; 1: 46-51. (in Russ.).
  5. Abramov E.K., Morozov Iu.I., Markov A.M. Problemy proktologii: tezisy dokladov. [Proc. Conf.
  6. "Problems of proctology"]. // Moscow. 1981; 107. (in Russ.).
  7. Akopian E.B. Mestnye vospalitel'nye posleoperatsionnye
  8. oslozhneniia paraproktitov. Diagnostika, lechenie i profilaktika
  9. [Local inflammatory postoperative complications of paraproctitis.
  10. Diagnosis, treatment and prevention. Cand. Diss. Med. Sci.]. //
  11. Tbilisi. 1981; 18. (in Russ.).
  12. An V.K., Rivkin V.L. Aktual'nye problemy
  13. koloproktologii: Materialy pervogo s"ezda koloproktologov
  14. Rossii s mezhdunarodnym uchastiem [Proc. 1st Cong. "Actual
  15. problems of Coloproctology"]. // Samara. 2003; 21-22. (in Russ.).
  16. Balaitis Iu.V., Poida A.I., Zhel'man V.A. [Features of development
  17. and generalization of infection in acute paraproctitis]. Pervyi
  18. Belorusskii mezhdunarodnyi kongress khirurgov. Sbornik
  19. nauchnykh trudov [Proc. 1st Int. Cong. Surg.]. // Vitebsk. 1996;
  20. -167. (in Russ.).
  21. Borodinets A.L., Ageev V.P., Kremen' V.E. [Results of treatment
  22. of acute paraproctitis]. Pervyi Belorusskii mezhdunarodnyi
  23. kongress khirurgov [Proc. 1st Int. Cong. Surg.]. // Vitebsk. 1996;
  24. -159. (in Russ.).
  25. Borodinets A.L., Rusinovich V.M., Kirkovskii V.V. Problemy
  26. koloproktologii. Sbornik nauchnykh trudov GNTs koloproktologii
  27. [Proc. GSC's of coloproctology "Problems of Coloproctology"]. //
  28. Moscow. 1998; 16: 31-36. (in Russ.).
  29. Vorob'ev G.I. Osnovy koloproktologii [Basics of Coloproctology]. //
  30. Moscow: Meditsinskoe informatsionnoe agentstvo, 2006; 432.
  31. (in Russ.).
  32. Vorob'ev G.I., Nikitin A.M., Rivkin V.L. Obsledovanie
  33. proktologicheskogo bol'nogo [The survey of proctological
  34. patient]. // Moscow, 1993; 28. (in Russ.).
  35. Goshchitskii L.G., Mozel' Iu.L., Mikhlin B.A. Sbornik "Problemy
  36. proktologii" [Digest "Problems of Coloproctology"], // Moscow.
  37. ; 14: 15–18. (in Russ.).
  38. Grigor'ev E.G., Shcherbatykh A. V. Klinicheskie lektsii po
  39. khirurgii. Chast' 2. Izdanie 4-e, pererabotannoe i dopolnennoe.
  40. [Clinical lectures on surgery]. // Irkutsk, Irkutskii gosudarstvennyi
  41. meditsinskii universitet. 2009; 220. (in Russ.).
  42. Dul'tsev Iu.V., Salamov K.N. Paraproktit [Paraproctitis]. //
  43. Meditsina. 1981; 206. (in Russ.).
  44. Zhakipbaev K.A., Makishev A.K., Mun N.V.
  45. Problemy koloproktologii: Sbornik nauchnykh trudov GNTs
  46. koloproktologii [Proc. of the GSC of coloproctology "Problems
  47. of Coloproctology"]. // Moscow. 1998; 16: 46-49. (in Russ.).
  48. Zaremba A.A. Klinicheskaia proktologiia [Clinical proctology]. //
  49. Riga: «Zvaigzne» Publ., 1987; 359. (in Russ.).
  50. Ishimov M.S., Khidiiatov I.I., Amirova D.Kh. [The possibility of
  51. using computed tomography in the diagnosis of deep forms of
  52. acute paraproctitis]. 3-ia Vserossiiskaia nauchno-prakticheskaia
  53. konferentsiia «Novye tekhnologii v khirurgii» [3rd Conf "New
  54. Technologies in Surgery"]. // Ufa. 129-130. (in Russ.).
  55. Kogan A.I. Materialy k patogenezu, klinike i terapii
  56. priamokishechnykh svishchei [Materials to a pathogenesis,
  57. clinic and therapy of rectal fistulas. Doct. Diss. Med. Sci.]. //
  58. Dnepropetrovsk. 1957; 31. (in Russ.).
  59. Mal'tsev V.N., Korolenko V.B. Vrachebnaia taktika pri ostrom
  60. paraproktite. Problemy reabilitatsii proktologicheskikh bol'nykh
  61. [Medical tactics to the patient with acute paraproctitis. Problems
  62. of rehabilitation of patients with proctologic pathology]. // Minsk.
  63. ; 19-20. (in Russ.).
  64. Masliak V.M., Stasyshin R.I. Aktual'nye problemy
  65. koloproktologii: Materialy konferentsii [Proc. of Conf. "Actual
  66. Problems of Coloproctology"]. // Nizhnii Novgorod. 1995; 272-
  67. (in Russ.).
  68. Naumov A.I., Maskin S.S., Gevorkov A.R. Endolymphatic
  69. therapy of the acute purulent paraproctitis. Aktual'nye problemy
  70. koloproktologii: Materialy konferentsii [Proc. of Conf. "Actual
  71. Problems of Coloproctology"] //. 1999; 94. (in Russ.).
  72. Oleinikov P.N., Baranov O.N., Nosov V.A. Sbornik tezisov 3 Vserossiiskoi nauchno -
  73. prakticheskoi konferentsii «Novye tekhnologii v khirurgii» [Proc.
  74. of Conf. "New Technologies in Surgery"]. // Ufa. 1998; 140-142.
  75. (in Russ.).
  76. Oleinikov P.N., Baranov O.N., Nosov V.A., Klimanov A.V. Ul'trafioletovoye oblucheniye krovi v kompleksnom lechenii
  77. bol'nykh s ostrym paraproktitom
  78. [Ultraviolet irradiation of blood in the complex treatment of
  79. patients with acute paraproctitis]. // Proc. of Conf. "New Technologies in Surgery". Ufa. 1998; 142-144
  80. Rivkin V.L., Bronshtein A.C., Fain S.N. Rukovodstvo po
  81. koloproktologii [Guidance of Coloproctology]. // Moscow, 2001;
  82. (in Russ.).
  83. Semionkin E.I. Koloproktologiia (Uchebnoe posobie)
  84. [Coloproctology (Tutorial)] // Moscow: ID MEDPRAKTIKA
  85. Publ., 2004; 234. (in Russ.).
  86. Seropian G.A., Bichev R.P.,Dezortsev I.L. Aktual'nye problemy
  87. koloproktologii [Proc. of Conf. "Actual Problems of
  88. Coloproctology"]. // Irkutsk, 1999; pp. 120-121. (in Russ.).
  89. Suvorova G.N. Osobennosti gistogeneza i regeneratsii priamoi
  90. kishki i ee sfinkternogo apparata. [Features of histogenesis and
  91. regeneration of the rectum and sphincter apparatus. Doct. Diss.
  92. Med. Sci.]. // Saransk. 2001; 42. (in Russ.).
  93. Sufiiarov R.S., Nurtdinov M.A., Gabidullin Z.G.,
  94. Gabdrakhmanova A.A. Lecheniye paraproktita, vyzvannoye
  95. assotsiatsii Sankt-Aureus s pr. Vulgaris, Morganellamorganii i
  96. Enterobacter aggl [Treatment of paraproctitis caused by
  97. associations St. Aureus with pr. Vulgaris, Morganellamorganii and
  98. Enterobacter aggl.] // Vestnik Iuzhno-Ural'skogo gosudarstvennogo
  99. universiteta. Seriia: Obrazovanie, zdravookhranenie, fizicheskaia
  100. kul'tura, 2012; 8 (267): 70-73. (in Russ.).
  101. Timerbulatov V.M., Kalanov R.G., Ishimov M.S Paraproktit
  102. [Paraproctitis]. // Ufa, 1998; 205. (in Russ.).
  103. Fedorov V.D., Vorob'ev G.I., Rivkin V.L. Klinicheskaia
  104. operativnaia koloproktologiia [Clinical operative proctology]. //
  105. Moscow, 1994; 450. (in Russ.).
  106. Fedorov V.D., Dul'tsev Iu.V. Proktologiia [Proctology]. // Moscow:
  107. Meditsina Publ., 1984; 384. (in Russ.).
  108. Khrenov V.E., Stygin O.V., Zvol'skaia E.Iu.
  109. Materialy konferentsii "Aktual'nye problemy koloproktologii"
  110. [Proc. of Conf. "Actual Problems of Coloproctology"]. // Nizhnii
  111. Novgorod. 1995; 304. (in Russ.).
  112. Shelygin Iu.A., Blagodarnyi L.A. Spravochnik po koloproktologii
  113. [Handbook of Coloproctology]. // Moscow: Litterra, 2012; 596. (in
  114. Russ.).
  115. Ektov V.N., Nalivkin A.I. Aktual'nye problemy koloproktologii:
  116. Tezisy dokladov [Abstracts of Conf. "Actual Problems of
  117. Coloproctology"]. // Rostov-na-Donu. 2001; 88. (in Russ.).
  118. Nelson R. Anorektal'naya abstsess svishcha: chto my znayem? [Anorectal abscess fistula: what do we know?] // Surg
  119. Clin. North Am. 2002; 82(6): 1139–1151.
  120. Sahni VA, Ahmad R, Burling D. Kakoy metod luchshe vsego podkhodit dlya
  121. vizualizatsiya perianal'noy fistuly? [Which method is best for
  122. imaging of perianal fistula?] // Abdom Imaging, 2008; 33: 26: 30.
  123. Senagore A.J. Intrarektal'noye i vnutri anal'noye ul'trazvukovoye issledovaniye votsenke kolorektal'nogo patologii [Intrarectal and intra-anal ultrasonography in the
  124. evaluation of colorectal pathology.] // Surg. Clin. North. Am. 1994;
  125. : 6: 1465-1473;
  126. Stoker J. at al. Endolyuminal'naya MRT pryamoy kishki i zadnego prokhoda:
  127. tekhnika, prilozheniya i podvodnyye kamni [Endoluminal MR imaging of the rectum and anus:
  128. technique, applications, and pitfalls.] // Radiographics. 1999; 19: 2:
  129. -398.
  130. Ustynoski K., Rosen L., Stasik J. et al. Podkova abstsess svishcha:
  131. Seton lecheniye. [Horseshoe abscess fistula:
  132. seton treatment.] // Dis. Colon Rectum. 1990; 33: 7: 602-605.
  133. Van Outryve M. Endoskopicheskoye ul'trazvukovoye issledovaniye v vospalitel'nom
  134. zabolevaniya kishechnika, paracolorectal vospalitel'noy patologii, i
  135. zaochnaya anomalii [Endoscopic ultrasonography in inflammatory
  136. bowel disease, paracolorectal inflammatory pathology, and
  137. extramural abnormalities.] // Gastrointest. Endosc. Clin. N. Am.
  138. ; 5: 4: 861-867.
  139. Van de Stadt J. Svishch v ANO: mesto rektal'nogo prodvizheniya loskut
  140. tekhnika. [Fistula in ano: the place of rectal advancement flap
  141. technique.] // Acta. Chir. Belg. 2000; 100: 3: 123-127.
  142. Van Tets W.F., Kuijpers H.C. Seton lecheniye perianal'nykh svishchey
  143. s vysokoy anal'nom ili rektal'nogo otkrytiya [Seton treatment of perianal fistula
  144. with high anal or rectal opening.] // Br. J. Surg. 1995; 82: 895-897.
  145. Veronikis D.K., Nichols D.H., Spino C. Nobl-MengertFish
  146. operatsiya-Revisited: kompozitsionnyy podkhod k stoykim
  147. rektovaginal'noy svishchi i slozhnyye defekty promezhnosti [The Noble-MengertFish
  148. operation-revisited: a composite approach for persistent
  149. rectovaginal fistulas and complex perineal defects.] // Am. J. Obstet.
  150. Gynecol. 1998; 179: 1411–1416.
  151. Wedell J., Meier zu P. Eissen et al. Razdvizhnaya zakrylkov dlya uluchsheniya
  152. [Lecheniye vysokogo urovnya svishchey Sliding flap advancement for
  153. treatment of high level fistulae.] // Br. J. Surg. 1987; 74: 390-391.
  154. Whiteford M.H., Kilkenny J., Hyman N. et al. parametry praktiki
  155. dlya lecheniya peri abstsessov i svishchey-v-ANO (v novoy redaktsii). [Practice parameters
  156. for the treatment of peri abscess and fistula-in-ano (revised).] // Dis.
  157. Colon Rectum. 2005; 48: 1337-1342.
  158. Zimmerman D.D., Delemarre J.B., Gosselink M.P., Hop
  159. W.C. et al. Kureniye vliyayet na iskhod transanal'noy slizistykh obolochek
  160. prodvizheniye loskut remont transsphincteric svishchey [Smoking affects the outcome of transanal mucosal
  161. advancement flap repair of transsphincteric fistulas.] // Br. J.
  162. Surg. 2003; 90: 3: 351-354.
  163. Zmora O., Mizrahi N., Rotholtz N. et al. Fibrinovyy kley zapechatyvaniya
  164. pri lechenii perianal'nykh svishchey. [Fibrin glue sealing
  165. in the treatment of perineal fistulas.] Dis. Colon Rectum.
  166. ; 46: 5: 584-589.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2013 ., .

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

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies