What is Perianal Abscess?
It is formed by the accumulation of inflammation as a result of inflammation of the glands in the anus / breech area.
- In obese / overweight
- In women
- Hygiene problems (excessive cleaning or too much dirt)
- It occurs more frequently with prolonged diarrhea, alcohol and regional irritations.
What is a perianal fistula, it means a leakage. It is the formation of a channel outside the anatomical structure where it should not be. It is most common especially around the anus / anus. These fistulas are called Perianal Fistula. If fistula has not formed yet, it is called Perianal Abscess. It is the most undesirable disease of the anal area. It has 2 outlets, external and internal orifice; the external orifice opens around the anus / anus and the internal orifice usually opens into the intestinal cavity.
It occurs when an abscess formed around the anus for various reasons cannot drain itself sufficiently or the inflammation does not heal completely and finds a way between weak tissues. If the external hole closes prematurely, it can constantly regenerate.
Sometimes it can occur in cases such as cancer, inflammatory disease of the intestine (crohn's disease), tuberculosis, immunosuppression, local trauma / injury.
What are the Symptoms of Perianal Abscess and Fistula?
Symptoms of perianal abscess, pain, stiffness, redness, temperature in the anal area, that is, 4 symptoms of abscess are seen. The patient does not know what to do from severe pain, cannot sit. If it bursts, there is foul-smelling discharge.
Abscess can cause fistulas over time. This rate is around 25-30%.
Symptoms of perianal fistula,
- Pain, swelling and a feeling of fullness in the anus area.
- Local hyperemia / redness and burning sensation.
- Inflamed, foul-smelling discharge and irritation. Sometimes there may be a bloody discharge.
- High fever. Sometimes there may be chills.
- Feces and gas coming out of the fistula's external opening.
- In case of re-abscess formation, pain, stiffness and fever occur. With the pressure of the abscess, there is a feeling of fullness in the anus area and pain increases during defecation.
Sometimes, in addition to difficulty in defecation, burning in urine and tenderness spreading to the legs can be seen.
How are Perainal Abscess and Fistula Diagnosed?
Peranal abscess can be diagnosed with a good examination. However, MRI may sometimes be required for differential diagnosis and detail.
Diagnosis of perianal fistula,
- Good patient analysis and physical examination
- Fistulography
- MRI is performed. These tests are also used to determine the cause of the fistula and the type of fistula (simple/complex/crohn's related...).
- Rectoscopy / colonoscopy can also be used in differential diagnosis.
How to Treat Perianal Abscess and Fistula?
Perianal abscess treatment is surgical drainage under local anesthesia. Antibiotics and painkillers should also be taken. Even if treatment is performed, fistula may develop in the future.
Recovery may be late in smokers and diabetics.
In addition, anal abscesses in diabetics can cause very dangerous conditions called Gangrene Fournier, which can be life-threatening.
Perianal fistula treatment, perianal fistula does not heal spontaneously, there may only be periods of stagnation. It does not heal without surgery. Along with surgery, a treatment program for gas and fecal incontinence should be applied. Patient education and exercises should also be done.
Surgery Fistulotomy / Fistulectomy, Seton application and Laser (short fistula) can be applied. Treatment of complicated fistula is long.
In addition, weight loss, improved hygiene and local care are important.
IMPORTANT NOTE: Without treatment, fistulas may develop cancer in the long term.
