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ABSCESS

ABSCESS. Symptoms. anorectal abscess causes severe and continuous pain. Patients may present with fever , nausea, vomiting. Physical examination reveals a tender perianal or rectal mass in inflamed surroundings. ANORECTAL ABSCESS. Diagnosis.

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ABSCESS

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  1. ABSCESS

  2. Symptoms • anorectal abscess causes severe and continuous pain. Patients may present with fever, nausea, vomiting. Physical examination reveals a tender perianal or rectal mass in inflamed surroundings.

  3. ANORECTAL ABSCESS

  4. Diagnosis • anamnesis and rectal examination may be sufficient, in some cases rectal ultrasound or CT may help

  5. ENDORECTAL ULTRASOUND abscess

  6. TREATMENT • The definite treatment is surgical; abscesses should be drained as soon as possible. Antibiotic prophylaxis parallel with surgery is useful only in case of diabetes, elderly patients, and immuno-suppression. Antibiotics for Gram – and Gram + bacteria are to choose.

  7. Periproctal abscess operation

  8. Haemorrhoid, 3rd degree

  9. Haemorrhoid, 4th degree

  10. LONGO OPERATION

  11. LONGO OPERATION

  12. LONGO PROCEDURE

  13. Conservative treatment One day surgery, thrombectomy remove the clot Good result Minimal complication Haemorrhoids with thrombosis

  14. MASSIVE BLEEDING FROM HAEMORRHOIDS • Excessive, transfusion-requiring bleeding may develop sometimes. • Diagnosis should be made using sigmoidoscope and/or colonoscope. • After excluding other sources of bleeding, and correcting the anaemia, surgical procedure may be performed.

  15. ANALFISSUREACUTE Alinear ulcer, usually situated in the posterior raphe of the canal. Fissures situated laterally are common in Crohn’s disease.

  16. ANALFISSURECHRONIC

  17. TREATMENT • Conservative: Laxative, fibre rich diet, paraffin oil Pain relief, anti-inflammatory treatment Nitrate-blocking ointment or creams to reduce the spasm of the internal sphincter muscle Use of Botox injections is in experimental phase • Surgical: If symptoms are permanent.

  18. Injury of the rectum • Mechanical, external injury may be caused by: • Sexual activity • Foreign body • Trauma • Incorrect episiotomies • High pressure injuries

  19. Injury of the rectum • Involve anal canal and sphincter muscle • Involve the upper part of rectum • Involve both part of rectum • Mixed injuries: rectum and pelvic region • Diagnosis: inspection, palpation, X-ray, CT • Sigmoideoscopy ( intraoperatively)

  20. Treatment of rectal injuries • Urgent operation • Rectum and sphincter reconstruction • Necrectomy and drainage • Colostomy • Foreign body removal ( per rectum or laparatomy ) • Antibiotics ( wide spectrum)

  21. FOREIGNBODY

  22. Condyloma acuminataBuschke-Loewenstein tumour

  23. Vernuille disease

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