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Painful anal conditions jaber
 

Painful anal conditions jaber

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  • Some estimate as hiegh as 90% >>>> gland in origion
  • As an abscess enlarges, it spreads in one of several directions. A perianal abscess is the most common manifestation and appears as a painful swelling at the anal verge. Spread through the external sphincter below the level of the puborectalis produces an ischiorectal abscess . Intersphincteric abscesses occur in the intersphincteric space and are notoriously difficult to diagnose Pelvic and supralevator abscesses are uncommon and may result from extension of an intersphincteric or ischiorectal abscess upward, or extension of an intraperitoneal abscess downward
  • The perianal space surrounds the anus and laterally becomes continuous with the fat of the buttocks. The intersphincteric space separates the internal and external anal sphincters. It is continuous with the perianal space distally and extends cephalad into the rectal wall. The ischiorectal space (ischiorectal fossa) is located lateral and posterior to the anus and is bounded medially by the external sphincter, laterally by the ischium, superiorly by the levator ani, and inferiorly by the transverse septum. The ischiorectal space contains the inferior rectal vessels and lymphatics. The two ischiorectal spaces connect posteriorly above the anococcygeal ligament but below the levator ani muscle, forming the deep postanal space. The supralevator spaces lie above the levator ani on either side of the rectum and communicate posteriorly. The anatomy of these spaces influences the location and spread of cryptoglandular infection
  • As an abscess enlarges, it spreads in one of several directions. A perianal abscess is the most common manifestation and appears as a painful swelling at the anal verge. Spread through the external sphincter below the level of the puborectalis produces an ischiorectal abscess . Intersphincteric abscesses occur in the intersphincteric space and are notoriously difficult to diagnose Pelvic and supralevator abscesses are uncommon and may result from extension of an intersphincteric or ischiorectal abscess upward, or extension of an intraperitoneal abscess downward
  • cruciate incision over the most fluctuant point, with excision of the skin edges to de-roof the abscess
  • If the abscess is secondary to intra-abdominal disease, the primary process requires treatment and the abscess is drained via the most direct route (transabdominally, rectally, or through the ischiorectal fossa).
  • Malignant lesions of the anus and anal canal

Painful anal conditions jaber Painful anal conditions jaber Presentation Transcript