Skip to main content
UploadLanguage (EN)Support
BusinessMobileSocial MediaMarketingTechnologyArt & PhotosCareerDesignEducationPresentations & Public SpeakingGovernment & NonprofitHealthcareInternetLawLeadership & ManagementAutomotiveEngineeringSoftwareRecruiting & HRRetailSalesServicesScienceSmall Business & EntrepreneurshipFoodEnvironmentEconomy & FinanceData & AnalyticsInvestor RelationsSportsSpiritualNews & PoliticsTravelSelf ImprovementReal EstateEntertainment & HumorHealth & MedicineDevices & HardwareLifestyle
Uploaded byHenyPatel19
PPTX, PDF9 views

Abstract Color Wave PowerPoint Templates.pptx

Proctitis - an inflammation in or on anus which a painful inflammation of the tissue around the rectum that can occur in cute or chronic factor. Its etiology can be stds, autoimmune disease,harmful physical agents.symptoms are pain,fever,chills, malaise,skin irritation,discharge of pus, constipation

Health & Medicine◦
Download to read offline
PROCTITIS AROUND RECTUM Proctitis isa painful inflammation of the tissues around the rectumthat can occur in acute or chronic forms.
ETIOLOGY STDs [M.C]- Gonorrhoea, syphilis,herpes, anal warts, chlamydia Non-sexually transmission from contaminated food [salmonella, shigella, campylobacter] Autoimmune disease Harmful physical agents- chemicals, foreign object placed in rectum, antibiotics
Entry through anal crypts Spreading way Damaged rectum mucosa Hematogenous and lymphogenous spread Imflammtory process in neoghbouring organs
Localisation 1. Subcutaneous paraproctitis 3. Ischial-rectal 5. Retrorectal 2. Submucosal paraproctitis 4. Pelvis and rectum Columnae morgani
SYMPTOMS SUBCUTANEOUS ABCESS SUPERFICIAL IS ASSOCIATED WITH- • Pain • Skin irritation-including redness ,tenderness • Discharge of pus • Constipation Deeper associate with- • Fever • Chills • Malaise PERIANAL ABCESS
CHRONIC PARAPROCTITISManifested festering fistula • Mouth of fistulous passage[ depends on tract’s path]: near the anus; on the buttock. • Pain is usually not expressed- unlike in acute • Pus – frequently flushes out of fistula • Presence of feces indicates connection to rectum’s lumen Factor contributing to chronic nature 1. Persistent infection source 2. Fistula tract characteristics [epithialization,granulation] 3. Reactivation of dormant infection
Diagnosis • Complains- pain in area of rectum and anus – can go with basic anal check up Ultrasound examination using rectal sensor Fistulography
OPERATIVE TREATMENT Surgical treatment of acute paraproctitis includes early emergency surgical intervention by opening the abscess with removal of pus and necrotic tissues, examination of the abscess cavity with a finger, separation of the bridges and drainage of the cavity. Choice of method of anaesthesia Patient position on operating table
Approaches to radical surgery 1. Opening > Drainage > cyst excision > FISTULA DISSECTION Fistulous tract is dissected and separated from surrounding tissue and opened into lumen of rectum ensuring complete drainage and removal of infected tissue. 2. Opening > Drainage > Crypt excision > SPHINCTEROTOMY A portion of anal sphincter muscle is cut. This approach is used when fistula tract runs through the anal sphincter muscle. 3. Dissection > drainage > crypt excision > LIGATION The fistulatous tract is tied off using suture. The aim is to interrupt the connection between the infected area and rectum . It is less common method for acute infections. 4. Dissection > Drainage > DELAYED CRYPT EXCISION > GUT FLAP MOVEMENT Abcess opened an drained. The removal of crypt is delayed until acute inflammation subsides. A flap of rectal tissue is moved to cover the opening and interrupt the communication btw rectum and infected area. This breaks the pathway for further infection and help to heal. Mostly used in severe cases.
• In order to help the examiner predict the trajectory of the tract and probable location of the internal opening, Goodsall's Rule can be applied. • With the patient in the lithotomy position :If the external opening is anterior to an imaginary line drawn-across the midpoint of the anus, the fistula runs straightly into the anal canal. • If the external opening is situated posterior to the line, the track usually will curve and the internal opening will be on the midline posterior of the anal canal. • An exception to this rule is when the external opening is anterior to this imaginary line but is situated more than 1½ inches away from the anus. In this case the track will curve posteriorly and end in posterior midline. Goodsaall’s rule
INCISION APPLY SEMILUNAR AND RADIAL INCISIONS [ they provide gapping wound which helps the purulent outflow] 1. For perineal abscess 2. Behind mousse 3. Ischiorectal Surgical approch for [1] ischiorectal [2] pelviorectal abcesses
DISSECTION – In subcutaneous paraproctitis Incision in- radial direction Retrorectal incision
Reassessment of abscess cavity
TREATMENT • ANTIBIOTICS s/a Doxycycline[oracea, vibramycin] • ANTIVIRAL drugs s/a acyclovir[zovirax] • Treatment to destroy damaged tissue – by this technique ablation which is bleeding can be removed • Medications in form of suppository, enema which helps in reducing inflammation and reduce bleeding. • Surgery
COMPLICATIONS • Purulent Fusion of the Rectum Wall with Spread of Intestinal Contents: This is the primary initiating event. The infection erodes the rectal wall. • Formation of a Purulent Fistula Between the Rectum and Vagina: • Purulent Melting of the Urethra and Spread to the Scrotum: • Breakdown of Pus into the Abdominal Cavity and Retroperitoneal Tissue: The most life-threatening complication is the spread of the infection into the free abdominal cavity. * Peritonitis; Retroperitoneal Phlegmon ;Sepsis;Death • Necrosis of the Skin: The skin overlying the abscess can undergo necrosis (tissue death) due to the pressure and destructive effects of the infection.
THANK YOU