1 Perianal abscess
Perianal abscess, also known as perianal abscess, is called anal carbuncle in Chinese medicine. Perianal abscess is an abscess that develops after acute purulent infection in the soft tissues or fascial space around the anorectal canal. It is generally believed that this kind of non-specific perianal abscess and anal fistula are two stages of the same disease development. Abscess is the early stage of anal fistula, which is the acute attack stage; anal fistula is the late stage of perianal abscess, which is the chronic stage of inflammation. The incidence of this disease is about 2%, accounting for 8% to 25% of anorectal diseases. It is more common in men between the ages of 20 and 40. The incidence of men is 3 to 4 times that of women, and the incidence of children is relatively high.
A perianal abscess should be treated seriously after it occurs. Because the abscess is not easy to absorb by itself, it is often not smooth even if it is penetrated and drained. Therefore, once the abscess is formed, surgery is the only reliable method. The sooner the better, even if there is a lack of fluctuation, it should not be Delaying, timely drainage, and waiting until the surface of the abscess fluctuates before making plans can only lead to the risk of inflammation spreading and aggravate the patient's pain. If not treated in time, it may cause septic shock and even life-threatening.
Two incarcerated hemorrhoids, hemorrhoids bleeding and thrombotic external hemorrhoids
1. Incarcerated hemorrhoids
Incarcerated hemorrhoids refers to the prolapse of hemorrhoids that can not be received in time, due to congestion, edema and thrombosis, causing swelling, pain, erosion, and necrosis to form internal hemorrhoids incarcerated. It mostly occurs in internal hemorrhoids and mixed hemorrhoids of degree III and IV. Incarcerated hemorrhoids are a common emergency in anorectal surgery and belong to the category of "turning hemorrhoids" in Chinese medicine. Modern medicine believes that the pathology of incarcerated hemorrhoids is acute and chronic inflammatory cell infiltration, and the hemorrhoid mucosa and vascular fibers are highly edema, which is a very serious stage of the development of hemorrhoids. Since the internal hemorrhoids and hemorrhoids are not incarcerated in the anal orifice in time after prolapse, the internal sphincter muscles continue to spasm, causing local swelling and pain, which seriously affects the quality of life. If the incarceration is not released in time, it will further cause mucosal or subcutaneous thrombosis , Ulcers and necrosis form widespread thrombosis, strangulation and necrotic hemorrhoids, and individual cases may even cause secondary bacterial infections. Generally, manual reduction is first used to make it return in time. For those who cannot be reduced, early surgery is more beneficial to the patient. The effect of conservative treatment is slow, the treatment course is long, and the patient suffers a lot. Emergency surgical treatment has the advantages of quick onset and short course of treatment.
2. Hemorrhoids bleeding
Hemorrhoids bleeding is always bright red, mildly manifested as blood on the toilet paper or dripping in the stool, and can stop after the stool; moderate to severe manifestations are bleeding or ejection in the stool, bleeding, and even coughing or farting Sometimes, hemorrhage from stool, excessive bleeding, and long course of disease can lead to moderate to severe hemorrhagic anemia. A large number of hemorrhoids bleeding is also an emergency in clinical work, which seriously affects the quality of life of patients. Sometimes medication alone has little effect and urgent surgical treatment is needed.
3. Thrombotic external hemorrhoids
That is perianal subcutaneous vein thrombosis, which is more common in clinical practice. Often due to the original varicose veins, the anal vein ruptures when the abdominal pressure suddenly rises such as forced defecation, and the blood forms an oval mass under the skin of the anal border, often accompanied by severe pain. Because this kind of pain is caused by the chemical irritation of the tissue caused by hemosiderin produced after blood clotting, it is not bacterial inflammation, and antibiotics are not effective. Some cause secondary infection after rupture. The treatment of thrombotic external hemorrhoids depends on the severity of the pain symptoms. If the pain is severe, immediate surgical removal is required.
Three necrotizing fasciitis
Necrotizing fasciitis, also known as Fournier syndrome, is a serious acute infectious disease mainly in the perineum. It is characterized by rapid onset, rapid progress, and severe disease. The local tissues can be extensively necrotic or even disabled. The severe cases often endanger the lives of patients, with a fatality rate of 13%-45%. While actively carrying out systemic treatment, including effective antibiotic application, maintaining water and electrolyte balance, etc., as soon as possible, extensive and thorough debridement and drainage is a key part of treatment, and is a fundamental measure to save patients' lives and vital organ functions.
Suffering from this type of anorectal "emergency" disease cannot be delayed for a long time, and you must go to a regular hospital for specialist examination and treatment in time.