Abscess, periproctiticK62.8
Synonym(s)
Anal abscess; Perianal abscess; Periproctitic abscess
DefinitionThis section has been translated automatically.
Abscess in the anal region.
EtiopathogenesisThis section has been translated automatically.
Mostly a consequence of an intersphincteric microabscess, which always starts with an intraanal infection. Spreading of the microabscess over given cleft spaces or in the lymphatic system.
LocalizationThis section has been translated automatically.
Perianal, ischiorectal, pelvirectal.
Clinical featuresThis section has been translated automatically.
Defecation pain, pressure or spontaneous pain, inflammatory redness or swelling.
Complication(s)This section has been translated automatically.
Anal fistula.
TherapyThis section has been translated automatically.
Remember! In the presence of fistulas, rule out Crohn's disease or tuberculosis.
Operative therapieThis section has been translated automatically.
- Surgical removal with a T-shaped or oval incision up to the primary focus while protecting the anal sphincter to avoid incontinence (puborectal loop) or an anal fistula.
- Smaller subcutaneous and submucous abscesses are incised and evacuated under local anaesthetic.
- Open and drain larger abscesses broadly: oval, star-shaped, diamond-shaped or T-shaped partial resection of the abscess cover under general anaesthesia, followed by careful deep curettage. Avoid a via falsa!
- In the presence of a recognizable fistula tract: primary splitting and tamponade insertion, healing of the wound per secundam.
AftercareThis section has been translated automatically.
- 1-2 dressing changes/day with antiseptic ointment (e.g. Braunovidon, Betaisodona ointment), wound gauze and sitz baths (e.g. Betaisodona perineal antiseptic), preparation of partial baths and compresses with antiseptic solutions such as potassium permanganate solution (light pink). Wound cleansing irrigation with polihexanide (Serasept, Prontoderm) or Ringer's lactate solution, see also wound treatment.
- Initial antiseptic ointment dressings, if the wound bed is clean, measures to promote healing.