2021年1月29日星期五

what does a hemorrhoids look like,Lecture 19: What is the matter with perianal abscess?

    Perianal abscess seems to be a scary thing, but in its essence, it is actually the same as ordinary abscess. When the body's resistance is insufficient, the inside of the tissue communicates with the outside world, and bacteria take the opportunity to enter. Bacteria destroys the tissues extensively, the tissues become corrupt and pus, and the pus cannot be discharged. It becomes an accomplice of the bacteria, increases the erosion of the tissues, and forms abscesses again and again.

    Why do I get perianal abscess?

    From the above, there are 3 prerequisites for the appearance of perianal abscess:

    ① Insufficient body resistance. In other words, the long-term fat and rich taste and eating and drinking have weakened your immunity unconsciously, making you defeated in the face of bacterial infestation.

    ②Exposed inside the organization. Unlike organs and tissues such as limbs and organs, the anal canal is the end of the digestive tract and the outlet for excrement, and it itself is in communication with the outside world. Due to the existence of anal sinuses and anal glands on the anal canal dental line, there are three ways for bacteria to contact the tissues:

    (1) The anal sinus on the tooth line looks like a kangaroo mother's big pocket (with the mouth facing up). When the stool passes through the door of the bag, some will enter the bag. The structure of the bag makes it difficult to discharge and stay. The bacteria in the stool begins to erode the anal sinuses and form anal sinusitis. The bottom of the anal sinus is connected to the anal gland through the anal gland duct, and the bacteria go straight to the anal gland along this tube, causing anal gland inflammation. The wall of the anal gland is just a thin film, which is easily pierced by bacteria and enters the surrounding tissues. The loose perianal tissue is like a maze, twists and turns, no one knows where the bacteria will go with the pus, so a complex abscess is formed. This is also the main reason for the formation of perianal abscess; photo:

    (2) Similar to other parts of the process, the perianal skin is damaged, so that the muscles, fascia and other tissues are in contact with the outside world;

    (3) In addition, the sweat glands and sebaceous glands of the perianal skin are very developed. Sometimes the sebum and hairs can become similar to bacteria after the pores are blocked, causing corresponding skin inflammation. When the inflammation spreads inward, an abscess may form. However, the abscesses caused by the latter two conditions can only be said to be perianal abscesses rather than perianal abscesses. Perianal abscess refers to an abscess that has an internal mouth communicating with the anal canal through the dental line, which is the first case.

    In addition, if the stool is dry or unshaped, too long to go to the toilet, long squatting and standing for a long time, if the pressure on the anal canal is too high, the stool can easily enter the anal sinus, causing a series of symptoms in the future.

    ③The erosive power of bacteria is strong enough. No matter how thin the walls of the castle are, some soft-footed shrimp will not be a problem.

    What kind of perianal abscess do I have?

    The classification of perianal abscess is mainly based on the location of the abscess: from deep to shallow, there are mainly pelvic rectal fossa abscess, rectal submucosal abscess (rectal pelvic part), posterior rectal abscess (rectal pelvic part), [above mentioned Abscesses above the anus muscle, followed by abscesses below the levator ani muscle] Ischiorectal fossa abscess, retroanal space abscess, anal submucosal abscess, perianal subcutaneous abscess and horseshoe abscess, etc.

    What are the manifestations of perianal abscess?

    Take anal gland infection as an example:

    ① One day suddenly, you feel a small lump or lump around the anus.

    ② Within a few days, there was sudden severe pain in the hard lump, local redness and heat, no touch, restlessness due to the pain, sleeplessness at night, or discomfort from anal swelling, fever throughout the body, cold or even chills, cold sweats, fatigue and fatigue , Loss of appetite, constipation, poor urination and other symptoms. Deep abscess can also cause perineum and sacrococcygeal swelling and pain, and even cause systemic poisoning symptoms. The above symptoms will vary depending on the type of abscess.

    ③An abscess will form after about a week. You will feel a large, soft and fluctuating mass. The temperature is higher than the surrounding skin, and the pain is less than before. After a squeeze, there may be a little white or yellow color in the anus. The pus is discharged.

    ④ After the abscess is formed, it can be incised and drained to completely drain the pus, or the pus can penetrate the skin by itself and flow out from the skin lesion. At this time, the pain is greatly reduced or even disappeared, the body temperature will be normal, and the general condition will improve.

    ⑤ If the pus wound does not heal, or the pus recurs after temporary healing, the fistula will be an anal fistula over and over again. This is the result of the pus not being drained cleanly. If it can be drained cleanly, coupled with frequent dressing changes, it can heal smoothly.

    How should I treat it, and what are the consequences of not treating it?

    In general, surgical drainage is not possible when pus is not developed, only anti-inflammatory treatment, or topical medication to support the pus. After the abscess is formed, surgical incision and drainage can be performed to clean the pus, scrape off the carrion, open the wound, and change the dressing frequently later , Strengthen immunity, and then wait for the wound to heal.

    Abscesses must be treated surgically. Unlike hemorrhoids, as long as you don’t think it gets in the way, you can decide for yourself whether to have surgery before incarcerated hemorrhoids cause severe pain or hemorrhoid bleeding causes anemia. Perianal abscesses are not so easy to talk about. Finally, it is not bad for it to penetrate the skin to form an anal fistula. At least the pus is drained. Just choose a convenient time to remove the anal fistula. If it does not come out on its own, we must cut a mouth to help it out, otherwise the bacteria in the pus will enter the blood along the corroded muscle blood vessels, which can easily cause bacteremia or toxemia, which is life-threatening. Therefore, it is necessary to reduce inflammation before the operation. At this time, don't consider the side effects of antibiotics or your buttocks will be pulled.

    What things should be paid attention to in daily life to prevent abscesses?

    I said before that there are three prerequisites for the formation of perianal abscess. We cannot change the physiological structure of the anal canal, and we can’t do anything about the virulence of bacteria. We can only start with immunity. So I have to change my eating and drinking style, build a good body, and if the immune system is strong enough, let it be more virulent, and I will not move. And to develop good bowel habits. If the stool remains moist and formed, it will not be easily scraped into the anal sinus by the anal sinus wall if it is discharged smoothly and comfortably.

    Is perianal abscess contagious? Will it turn into cancer?

    Generally not, but after all, it involves bacterial infection. If someone else is infected with some highly infectious and virulent bacteria, it is not necessarily. But not necessarily you will get perianal abscess, maybe it is something else. The abscess itself will not turn into cancer. It takes a long time to become a cancer. You can't bear it at that time. However, the pus drainage is not complete, and the perianal tissue is repeatedly stimulated. Over time, no one dares to guarantee votes. Attached drawing:

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