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connectors, puncture and drainage bags, etc

The general manifestation of this disease is that the patient first feels the swelling pain or tingling in the anus, which can touch a hard lump and tenderness, followed by aggravation of pain, enlargement of painful mass, and chills and fever. Local abscess can be formed after 3 ~ 5 days. The local symptoms of low-level abscess are heavy and the systemic symptoms are light, while the systemic symptoms of high-level abscess are heavy and the local symptoms are light. The abscess can break into the anus and rectum by itself, and spontaneously discharge pus. After discharging pus, the pain is relieved, and the systemic symptoms improve or disappear. After the formation of anal fistula, the abscess can occur repeatedly.
Due to the different location of abscess, its symptoms and signs also have their own characteristics:
1. Perianal subcutaneous abscess accounts for 40% ~ 45% of perianorectal abscess. It is located in the subcutaneous tissue at the lower part of anus and anal canal, and the upper part is separated by fascia and sciatic rectal space. It mostly occurs on the posterior side of the anus. Swelling and pain in the anal area are the main symptoms of the disease. During the examination, local redness, tenderness and painful lumps can be seen. There is wave motion after suppuration. If it breaks by itself, there can be tears and pus. The diagnosis of this disease is easy. If an abscess is suspected, it can be confirmed by puncture.
2. Sciatic rectal fossa abscess, accounting for 15% ~ 25% of perianal abscess, is located in the sciatic rectal fossa. The sciatic rectal space is wedge-shaped, between the levator ani muscle and the sciatic bone, the bottom is the skin between the anus and the sciatic tubercle, and the tip is upward at the membrane connection between the muscular fascia and the levator ani muscle in the obturator. At the beginning of inflammation, you often feel discomfort or slight pain in the anus, followed by systemic symptoms, such as headache, elevated body temperature, accelerated pulse, chills, etc. at the same time, local pain is aggravated, restlessness, especially when defecating. He has difficulty urinating and is in a hurry. During physical examination, it can be seen that the anus is swollen, the skin is purplish red and hard, and the sciatic rectum fossa can be touched by finger diagnosis, which is full, swollen and tender. Early sciatic rectal fossa puncture is the simplest and effective method to find abscess.
3. Pelvic rectal space abscess accounts for about 2.5% ~ 9% of perianal abscess. The pelvic rectal space is located in the pelvic cavity, with levator ani muscle below, pelvic peritoneum above, and rectum and lateral ligament behind. The anterior male is bladder and prostate, and the female is uterus and broad ligament. After the occurrence of abscess, the main manifestations are systemic poisoning symptoms, and the local manifestations of anus are not obvious. Swelling and tenderness can be felt above the levator ani muscle by finger diagnosis. Due to the deep location of the infection, early diagnosis is not easy. Therefore, for those who cannot find the focus due to systemic infection and poisoning symptoms, or even septic shock, the possibility of the disease should be considered. B-ultrasound or CT examination can help diagnose.
4. Horseshoe abscess. Horseshoe abscess is an abscess that spreads behind and on both sides of the anus and anal canal. Most of it is in the rear. It is caused by infection of the posterior middle anal gland or the spread of one side of the abscess to the opposite side. It can be divided into high horseshoe abscess and low horseshoe abscess. In addition to the symptoms of systemic infection, the local manifestations were swelling and tenderness behind the anal canal, ulceration and pus in the later stage.