ANO-RECTAL ABSCESS
Ischio-rectal abscess is a type of anorectal abscess
A localized infection, anorectal abscess appears as a collection of pus due to inflammation of the soft tissue.
Causes
1. Infection of pathogenic microorganisms (Escherichia coli, staphylococci or streptococci)
2. Trauma abrasive contact with enema tips, ingested eggshells, fish bones or very hard stools
3. Ulcerative colitis and Crohn's disease.
4. Obstruction of glands in the anal area, extension of cryptitis, infection in the apocrine glands or folliculitis in the perianal region.
Clinical Manifestations
- Superficial abscess-swelling, redness and tenderness.
- Deeper abscess lower abdominal pain and fever. Painful reddened bulge or swelling near anus, pain increases with sitting; moderate - severe pain, pus may drain.
Medical Management
- Sitz baths and analgesics
- Incision and drainage of purulent exudate
- When deeper infection exists, possibility of fistula remove the fistulous tract
Nursing Management
- Assess wound
- Administer analgesics and sitz baths
- Note the time of the 1ยช post-operative bowel movement. Anticipating pain, the patient may suppress the urge to defecate; the resulting constipation would increase pressure at the wound site. Administer stool-softening laxatives as prescribed.
Complications
Anorectal fistula.
Types of anorectal abscess:
1. Perianal abscess - Red, tender, localized oval swelling close to the anus. Pus may drain from the abscess.
2. Ischiorectal abscess affects 15% of patients involves the entire perianal region on the affected side of the anus. Palpation reveals tenderness. The abscess may not produce drainage. Digital examination detects a tender induration bulging in to the anal canal.
3. Submucosal or high intermuscular abscess: Abscess may produce tenderness and occasionally induration causes a dull, aching pain in the rectum
4. Pelvic rectal abscess Malaise, myalgia, fever but no local anal or external rectal signs or pain
Comments
Post a Comment