surgical procedures and management

Apr 15th, 2015
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ANORECTALSURGICALCONDITIONSIIDR. GEORGE W. O. MUGENYAMBChB, MMed, FCS (ECSA)ANORECTAL ABSCESS2Anorectal abscess is an acute form of analsepsis.Etiology Infection of obstructed anal glands (mostcommon) Trauma Foreign body Tuberculosis Actinomycoses Inflammatory bowel diseaseANORECTAL ABSCESS3Pathology:The infection usually starts in one of the cryptsof Morgagni and extends along the related analgland to the inter sphincteric plane where itforms abscess.Soon it tracks in various directions to producedifferent types of abscesses which are classifiedas follows: Perianal abscess (60%) Ischiorectal abscess (30%) Sub mucous abscess (5%)ANORECTAL ABSCESS4ANORECTAL ABSCESS5ANORECTAL ABSCESS6PERIANAL ABSCESS Results from suppuration of anal gland orsuppuration of a thrombosed external pile Lies in the region of subcutaneous portion ofexternal sphincterClinical features Severe pain in perianal region Difficulty in sitting Tender smooth and soft swelling in the perianalregionANORECTAL ABSCESS7Treatment:Sitz bathAntibioticsDrainage under GAANORECTAL ABSCESS8ISCHIORECTAL ABSCESS Due to extension of intermuscular abscessthrough external sphincter Can be blood born as well Fat in fossa more prone for infection as it isleast vascularized Both these fossa are connected one fossainfection may lead to the infection on o

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