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Anorectal abscess (also known as an anal/rectal abscess or perianal/perirectal abscess) is an abscess adjacent to the anus. [1] Most cases of perianal abscesses are sporadic, though there are certain situations which elevate the risk for developing the disease, such as diabetes mellitus, Crohn's disease, chronic corticosteroid treatment and others.
Anorectal Abscess and Fistula: Painful swelling, [5] Redness, Pain, [10] Bloody diarrhea, [11] an opening can point to a fistula, with or without drainage [5] with itchiness. [12] Visual Exam, Digital Rectal Exam, Anoscopy, Imaging (CT, MRI) of the fistula tract, endoanal ultrasound, Labs, [11] exam under anesthesia. [11]
Endoanal ultrasound is a type of medical investigation which uses ultrasonography to show images of the structures of the anal canal. [1] It is used in the investigation of some anorectal symptoms, e.g. fecal incontinence or obstructed defecation .
Before the procedure, the patient is given a spinal or general anaesthetic and is placed in the lithotomy position (legs in stirrups with the perineum at the edge of the table). In the diagnostic phase, the fistuloscope is inserted into the fistula to locate the internal opening in the anus and to identify any secondary tracts or abscess cavities.
The inflammation is sometimes limited to the formation of an anorectal abscess, and in some cases it spreads for a considerable distance and may be complicated by sepsis. The symptoms are acute pain in the rectal region, tenderness during defecation, elevated body temperature, and the appearance of an infiltrate in the anal region or on the ...
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The final structure of the abscess is an abscess wall, or capsule, that is formed by the adjacent healthy cells in an attempt to keep the pus from infecting neighboring structures. However, such encapsulation tends to prevent immune cells from attacking bacteria in the pus, or from reaching the causative organism or foreign object.
Endoanal ultrasound can determine the depth of the ulcer and the structure of the external and internal anal sphincters. [8] Endoanal ultrasound findings in SRUS include: Lack of distinction between the mucosa and the muscularis propria. [1] Thickening of the rectal wall. [5] Thickening of muscularis propria. [1] Thickening of submucosal layer. [1]