It is the name given to the pus-filled space formed around the anal canal. The anal canal constitutes the last part of the digestive system and there are two muscle structures surrounding the anal canal. It is called the "external anal sphincter", which consists of the voluntary contracting-relaxing, striated muscle structure on the outside, and the "internal anal sphincter", which consists of the involuntary smooth muscle structure inside it. Thus, the anal sphincter formed allows the person to control the outflow of stool and gas. The glands in the anal canal are located between the two muscle layers surrounding the canal and discharge their secretions into the anal canal at the junction of the mucosa (the layer covering the inner surface) of the intestine and the skin, within 2-3 cm of the anal canal. The main function of the glands is to facilitate the defecation process by increasing the lubricity of the anal canal.
The reason why I made these detailed anatomical descriptions is so that non-medical people who read it can better understand the source of abscesses and fistulas that may occur in this region and understand the importance of the sphincter structures on which the treatment will be performed. .
Going back to our topic; Perianal abscess occurs as a result of bacterial infection or blockage of the glands around the anal canal described above. Abscesses may occur in different locations, superficial-deep, etc., depending on the direction of inflammatory spread.
WHAT ARE THE SYMPTOMS OF PERIANAL ABSCESS?
- Pain in the anus
- Swelling in the anus
- In addition to "local symptoms" such as increased temperature or itching in the anus
- Systemic symptoms such as fever - chills - chills and
- Weakness
HOW IS PERIANAL ABSCESS DIAGNOSIS?
- Physical examination and rectal examination
- Endoscopy / anoscopy – rectoscopy
- Imaging (Pelvic MRI or Pelvic CT / Endo Anal Ultra Sonography – ERUS)
- Diagnosis can be made by examination under anesthesia.
HOW IS PERIANAL ABSCESS TREATMENT PROVIDED?
Treatment of perianal abscess can be provided by "surgical"intervention. Abscess is treated by draining the pus through an incision in the overlying skin. Then, a drain is placed in the space (cavity) where the abscess was drained, aiming to continue the drainage. or buffer application is made.
This attempt; While it can be done with local anesthesia, deep and large abscesses may require general anesthesia in operating room conditions. Often, patients may need to be given antibiotics after the abscess is drained, and diabetic or immunocompromised patients may need to be hospitalized. It may take approximately 4-6 weeks for the abscess cavity to be filled with tissue, provided that appropriate conditions are met.
In this 4-6 week period after the surgery; It is necessary to clean the anal area, ensure the formation of shaped stools with a fiber-rich diet, and monitor the healing by making frequent dressings. Proper implementation of these measures reduces both problem-free wound healing and the risk of recurrence of perianal abscess.
In summary, as its name suggests, perianal abscess is an abscess that occurs around the anus. It can be easily treated by taking the right treatment measures.
However, the important thing to know in this regard is that approximately 1/3 of perianal abscess patients do not recover. In one third of the patients; Either abscesses recur or the drained opening does not close and "Perianal Fistula" develops, which is considered the "chronic phase" of abscess development.
In summary ; About 35-40% of abscess patients develop another disease that causes more troublesome clinical complaints, takes a long time to treat, progresses with relapses, and requires an experienced surgeon.
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