Paraproctitis is an inflammation of the tissues around the rectum and anus caused by bacteria such as E. coli and Staphylococcus aureus, resulting in a pus collection in the anorectal area. It can be classified as subcutaneous, submucosal, ischiorectal, pelvorectal, or retrorectal depending on the location of the abscess formation. Surgical drainage of the abscess is often indicated and involves making a semilunar incision to drain the pus and eliminate the internal opening using instruments such as a scalpel, clamp, and grooved probe. Complications can include spreading of the inflammation, rupture of the abscess, or burst of

1. Paraproctitis
GROUP- 414
BY- Arora Vrushit
Baxi Niyanta
Bhanderi Bhakti
Joshi Deep
Zala Chandni

2. Definition
• It is a purulent inflammation of the paraproctium
(cellular tissues around the rectum and anus).
• i.e, collection of pus in anorectal area.
• ETIOLOGY: E.coli; Staphylococcus aureus;
Streptococcus; Clostridial anaerobes; Cl. Hystoliticum.

3. Anatomy
Anus, rectum and anal canal
Anal canal has muscles: (i) internal anal sphincter
(involuntary)
(ii) external anal sphincter
(voluntary)
Levator ant muscular pelvic diaphragm
Support pelvic vessels & control urinary and faecal muscles
peritoneum lines.
Pectinate line/ dentate line
Above pectinate line endoderm origin below pectinate is
ectoderm origin. ( sensitive as their skin).

4. Classification
Paraproctitis
Subcutaneous
Submucosa
Ischiorectal
Pelvorectal
Retro Rectal

5. Abscess Formation
Subcutaneous/submucosal abscesses lies at the perineal space.
Ischiorectal abscesses located above the muscle that raises the
anus.
Pelvo-rectal abscesses is formed between the levator ani muscle &
the rectum.
Retro-rectal abscess present between rectum and sacral bone.

6. Indication: inflammation of
tissue around the rectum and
anus.
Surgical approach: Radical
Instruments: scalpel, Kocher
clamp, rectal speculum,
grooved probe.
Procedure: drainage of
abscess elimination of its
internal opening, semilunar
incision, pus is drained,
grooved probe is delivered
from the wound through the
opening of rectum.
Operation
Procedure

7. Complications
• Spreading of inflammation to the cellular tissue
of the pelvis, purulent fusion of the wall of the
rectum higher than the level of anorectal line.
• Break of pus into the abdominal cavity and
retroperitoneal space.
• Burst of pus from the abscess cavity through the
perineal skin.
• Rupture of abscess in lumen of rectum or
vagina.

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