Infection of the subcutaneous fat that surrounds the lower parts of the rectum is called paraproctitis. In newborns, this process is nonspecific and is characterized by the entry of purulent microorganisms into the cellular space of the gastrointestinal tract. The disease affects children less often than adults, but studies have found that in 60% of cases, the disease occurs most often in a newborn or infant.

What is childhood paraproctitis?

The onset of the disease in childhood is characterized by the body’s lack of ability to filter pus-like microbes that affect the intestinal walls. It is known that in childhood the disease can manifest itself as a monomicrobial flora.

A growth of a retention nature appears in places where the intestinal mucosa is damaged, which is the result of difficult passage of feces. This formation opens and infects the perinatal region, which means the development of acute paraproctitis. Next, the pus concentrates - in most cases it breaks out on its own, but it happens that you have to turn to surgery for urgent surgery.

In most cases, the chronic course of the disease is manifested by the reappearance of paraproctitis symptoms after treatment.

Scheme of development of paraproctitis

Causes of development and symptoms of paraproctitis

There are several reasons that cause the development of the disease, but the main one is infection. Various factors act as pathogens:

• streptococcal virus;
• staphylococcal virus;
• protein abuse;
• anaerobic formation on the intestinal walls;
• coli

The infection can penetrate into the cells of the rectum, for example, into hematogenous and lymphogenous areas, from cracks susceptible to infection and microtrauma of the mucous membrane. Caused by constipation hemorrhoids.

The infection has the ability to penetrate into the pararectal tissue due to blockage of the anal gland ducts. Initial inflammation occurs only at the mouths of the glands. Then the bactericidal formations penetrate further into the deeper layers of the intestinal wall. Inflammation spreads to the adjacent pararectal tissue, causing paraproctitis.

Pathogenic microbes enter cells during any chronic infectious pathology:

• tonsillitis;
• caries;
• sinusitis.

The main reasons for the development of pathology in children seem to be infections of the intestinal tract; they weaken the immune system and disrupt the intestinal microflora.

Diagnosed paraproctitis in children under one year of age requires immediate treatment. Doctors note that it is advisable to treat a 6-year-old child without surgery, which is why it is so important to know the first signs of the development of the disease.

Paraproctitis tends to occur suddenly, and its appearance is accompanied by serious symptoms and depends on:

• location of the inflammation process;
• formation diameters;
• type of pathogen;
• the body's ability to resist.

Characteristic manifestations of the disease:

• chills and fever (temperature rises to 38-39 °C);
• signs of intoxication appear - weakness, headaches, joint and muscle pain, loss of appetite;
• urogenital pathologies and stool disorders (accompanied by constipation), pain during urination and defecation;
• pain of varying intensity in the rectum/lower abdomen, which becomes much worse during bowel movements.

Paraproctitis makes the baby restless and whiny

Different forms of the disease have their own characteristics. For example, the subcutaneous tissue often swells, the tissue around the anus becomes tight and red, painful on palpation, and the person cannot sit. The source of inflammation can be seen with the naked eye.

Diagnosis of the pelvic rectal form is much more difficult, since foci of inflammation are located deep in the pelvic area and appear only with general symptoms.

Typically, parents attribute symptoms to colds, ignoring the risk of possible complications. You should consult a doctor if you suspect paraproctitis if:

• the condition does not improve after treatment with cold and flu medications;
• the baby’s general well-being is only getting worse;
• the child’s weakness is more pronounced;
• Problems with bowel movements and urination worsen.

In such cases, it is necessary to urgently begin to treat the disease, otherwise it will cause constant relapses in the future.

Treatment methods for children with paraproctitis

There are 2 main methods to treat the disease. Many doctors resort to complex measures.

Conservative methods

With a conservative method of treating paraproctitis in children, doctors prescribe local remedies in the form of baths, lotions and enemas. A very good result in relieving the symptoms of acute paraproctitis is given by a honey enema, which remarkably helps against paraproctitis in infants.

Despite the fact that folk remedies often help get rid of the problem without surgery, this does not mean that they are suitable for every child. In severe forms of the disease, parents should minimize the risk of complications and turn to surgical treatment methods.

Washing the rectum with a honey enema can ease the course of the disease.

Operative methods

To eliminate pathological formations, surgery is effective, prescribed for any severity of the disease (acute and congenital paraproctitis, detected in infants). The operation is performed under epidural anesthetic or gas anesthesia. This method consists of opening and draining the abscess, mechanically removing the inflamed abscess and closing the pathways through which the infection spreads to other parts of the intestine. Only the use of such measures can completely relieve children from acute paraproctitis. If infiltrates are detected inside the fistula, intensive antibacterial therapy and physical therapy are prescribed.

Preventive measures for paraproctitis

Carrying out preventive measures can reduce the likelihood of the disease occurring. Since children are not able to provide the necessary care themselves, this responsibility falls on the shoulders of the parents.

1. Prevent constipation - massage, ensure proper nutrition.
2. Avoid microtrauma of the anus.
3. Do not allow your baby to swallow foreign objects that could cause damage to the intestinal mucosa.
4. Bath or wash your baby after each bowel movement.
5. Provide timely medical assistance if any intestinal infection occurs.
6. Strengthen the body in accordance with the doctor’s recommendations.
7. Conduct preventive examinations with pediatricians according to the established schedule.

Parents need to carefully monitor the baby’s hygiene to avoid paraproctitis

In childhood, paraproctitis is practically no different from cases in adults. It occurs in acute and chronic forms. Symptoms, reasons why symptoms of the disease may occur and therapeutic measures are the same.

In children from one month to one year, the causative agent is usually a staphylococcal infection and rashes that appear where the skin comes into contact with the diapers.

The first thing parents should do is show the child to a pediatrician; self-medication is prohibited. This will only worsen the situation and lead to the development of a chronic form and possible complications in the future.

You can learn about methods of non-surgical treatment of paraproctitis from the video:

Most often, paraproctitis appears in boys in the first year of life. This name refers to inflammation of the anal glands, which develops against the background of bacterial infection of the tissues of the lower parts of the rectum. Parents should know the symptoms of paraproctitis in children in order to promptly seek qualified medical help.

Development of the disease

In 60% of cases, the disease is detected in infants under 6 months, 20% of all identified cases of this lesion are diagnosed at the age of 6-12 months. The older the child gets, the less likely it is to develop the disease. In infancy, the immune system is not yet mature, making it difficult for the body to resist various infections.

Through microcracks or injured areas of the mucous membrane, microbes enter the rectal tissue. As a result, purulent inflammation develops - paraproctitis in infants. The accumulated pus may begin to come out, but in some it moves into the abdominal cavity and peritonitis develops. If left untreated, this purulent inflammation can cause serious damage to internal organs by purulent masses.

In newborns and infants, paraproctitis occurs as follows. Initially, a bluish and practically painless spot forms in the perineal area. Many people develop an ulcerative lesion with jagged edges, and whitish deposits are visible at its bottom. Over time, the formed whitish stones may come out and the ulcer will heal. But some people develop fistulas.

Parents can notice a fistula in a child’s bottom almost immediately after birth. This is a congenital form. The opening may release feces or cloudy secretory fluid. If the fistula tract becomes infected, an inflammatory infiltrate appears and an abscess develops. It can open outward or into the intestinal lumen.

Symptoms and diagnosis of the disease

For timely detection of the disease, you should know how it manifests itself. During its development:

• disturbances in the process of defecation occur (diarrhea, constipation);
• pain occurs during urination or defecation, and the child begins to cry a lot;
• appetite worsens;
• temperature rises;
• a characteristic swelling appears in the perianal area;
• the vessels in the anal area are filled with blood;
• During the time of changing the diaper and washing the child, anxiety increases noticeably.

But parents should be wary not only of excessive anxiety and severe crying during bowel movements. Many children develop lumps on the skin around the anus that are firm to the touch. The skin of the buttocks turns red, they become swollen and painful. The folds of the anal mucosa are smoothed out.

If these signs occur, the baby should be shown to a pediatrician and proctologist. The specialist will examine the child and perform palpation. Such an examination allows you to determine the location of the abscess and determine its size. In addition, blood is taken for analysis: the number of leukocytes and ESR are determined. These indicators indicate the presence of a bacterial infection in the body.

In some cases, an ultrasound or x-ray is performed. If the development of pathology is caused by calcium salts deposited in a given area, they form stones (conglomerates). Their shadow will be visible on the x-ray.

Reasons for the development of pathology

Paraproctitis in infants begins as a result of infection of the anal sinuses or glands. In most cases, the lesion is caused by staphylococcus or E. coli. Microorganisms from the anal glands enter the adipose tissue in the area of ​​the rectum.

The inflammatory process quickly spreads through the ducts of the anal glands, which have numerous channels and branches. Because of this, the infection spreads quickly. Pus can even affect the internal organs of a baby.

Among the main reasons for the development of paraproctitis in children are the following:

• frequent loose stools, which damage the anal area;
• constipation, fecal retention: when passing through the rectum, solid feces injure the mucous membrane, because of this pathogenic microflora can penetrate the anal glands;
• congenital problems, pathologies with the mucous membranes of the rectum;
• immaturity of the baby's immune system;
• disruption of the formation of gastrointestinal microflora;
• violation of hygiene standards and rules when caring for infants.

Any diaper rash or irritation in the anal area is an entry point for pathological microflora.

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Types of disease

In infants, acute paraproctitis is most often diagnosed. Depending on the location of the main abscess, it can be:

• subcutaneous;
• submucosal;
• ischiorectal (rectal-sciatic);
• pelviorectal (rectal-pelvic);
• retrorectal.

In children, subcutaneous paraproctitis is most often found in the acute phase.

The disease becomes chronic if a fistula with an internal or external opening occurs. If it comes out on the skin, then they speak of an incomplete open fistula. If an outlet into the rectum has formed from the abscess, it ends in the tissue near the rectum and does not have access to the skin, then they speak of an incomplete closed fistula.

Rectal fistula in newborns can be a congenital pathology. Even if it was incomplete, when pathogenic microflora enters it and the infection process begins, it becomes complete. This means that an opening appears into the rectum and skin. Most often, fistulas form inside the sphincter - the muscles that close the passage to the rectum.

Chronic paraproctitis can periodically worsen. In this case, children experience the same symptoms as in the acute form.

Choice of treatment tactics

If parents consult a doctor in a timely manner, conservative therapy will be prescribed. Treatment without surgery is quite possible. The doctor will prescribe antibacterial drugs, antiseptic and anti-inflammatory local agents. Correctly selected treatment tactics can prevent the development of suppuration and the disease will not become chronic.

• use ichthyol ointment or Vishnevsky ointment;
• UHF procedures;
• microenemas;
• ultraviolet irradiation.

In addition, children are given warm sitz baths with a solution of potassium permanganate or other disinfectants. The water is made quite warm - up to 39-40 0 C. If we are talking about children in the first months of life who cannot yet sit, then they are bathed in a prepared weak disinfectant solution several times a day.

If there are fistula passages, it is necessary to carry out all preventive measures recommended by doctors. These include:

• timely hygiene and removal of feces from the anus;
• thorough cleaning and care of the skin in the anal area;
• using mild baby laxatives or massaging the abdominal area to prevent constipation and stagnation of feces in the baby’s intestines.

In cases where acute paraproctitis is diagnosed and an abscess has already formed, surgery is prescribed. The above conservative methods are also recommended for use in preparation for surgery. If no improvement is observed with their use, then surgery cannot be avoided.

Surgical treatment of paraproctitis in children under one year of age is carried out as follows.

1. The surgeon opens the abscess and removes the accumulated pus. In this case, drainage is left in the cavity and antibacterial treatment is carried out at the same time.
2. 3-4 days after the baby’s condition normalizes, the drainage is removed.

According to this scheme, operations are performed on children under 2 years of age.

Older children undergo an operation during which the affected tissue is excised and accumulated pus is removed. It is usually done in cases where a complete fistulous tract has been formed. It is excised or bandaged. If calcium stones are present, they are removed using special tweezers or a sharp spoon.

There is no point in applying bandages to the surgical area; they become contaminated with feces. After surgery, a special drainage tampon with Vishnevsky ointment is installed. Its presence will prevent premature closure of the wound cavity. It is removed only a few days after the operation.

After surgical treatment, a special diet and antibiotic therapy are prescribed, and cleansing enemas are performed. At the same time, medications are prescribed to restore intestinal microflora. The doctor may recommend Lactobacterin, Bifiform.

In most cases, after surgery, the child’s condition returns to normal and there are no relapses of the disease. But with conservative therapy and when the abscess opens on its own, a re-exacerbation is possible.

According to the data, pathology is registered most often in babies under one year old, and more often in boys. The main cause of the disease will be gross violations of personal hygiene rules, when children spend too long in a dirty diaper. Feces are an excellent breeding ground for the proliferation of pathogenic flora; the moist and warm environment of the diaper adds fuel to the fire. Infection from the intestinal lumen penetrates into the fiber with the subsequent formation of purulent inflammation and an abscess. The cause of purulent inflammation is often representatives of staphylococci.

A predisposing factor may be structural features - the ducts of the anal glands, which have branches, along which they spread to more favorable places for inflammation.

Also, the cause of inflammation can be various injuries to the anus, some inflammatory diseases - hemorrhoids, the formation of cracks.

Symptoms

In clinical practice, acute and chronic inflammation are distinguished. Acute paraproctitis is characterized by an acute and sudden onset. The child has an increase in body temperature, and up to high numbers. The baby will complain of poor health, lack of appetite, whims and crying for no reason. During the act of defecation, the pain intensifies, which becomes an intensification of crying.

Older children may complain of pain in the anus or in the projection of a formed fistula. When examining the child, this area becomes swollen and red. On palpation, it becomes hot to the touch.

In addition, specific symptoms will form depending on where the abscess is located, on the surface or in the deep layers. If the abscess is located deep, then the symptoms will slowly increase, and the first symptoms will only be an increase in temperature and deterioration in well-being. The pain reaction when visiting the toilet is insignificant, but gradually intensifies.

Diagnosis of acute paraproctitis in a child

Only an experienced doctor can make a diagnosis, sometimes this is a whole tandem - a pediatrician, a surgeon and a proctologist, who not only prescribe a list of studies, but also develop a treatment plan. When the first complaints and symptoms appear, you must immediately seek help from specialists. At the appointment, the doctor needs to talk about the child’s behavior, increased body temperature, crying, and what will contribute to its intensification.

Subsequently, the doctor proceeds to a direct examination. Parents and doctors should be especially wary of redness of the anus and the appearance of severe crying during palpation. Even spreading the buttocks for examination can cause severe pain.

Additional research methods may include laboratory tests of blood and feces, and visual examination methods to diagnose the location of the pathology and its size. As a rule, doctors prescribe ultrasound, radiography, probing, etc.

Complications

Complications and consequences develop as a result of irrational and untimely treatment. The most common complication will be the transition of acute inflammation to chronic. If left untreated, the abscess can rupture and melt the intestinal wall.

The most serious complication that can threaten the life of a child is an abscess breaking into the pelvic cavity.

Treatment

What can you do

Treatment of pathology can only be carried out by specialists in a hospital. The main task is to remove pus and excision of the abscess, i.e. only surgical treatment. The main task of parents is to suspect pathology in a timely manner and take all necessary measures.

The operation itself is performed under general anesthesia, which is associated with some risks. Therefore, all preparation should rest on the shoulders of the parents. In the future, after treatment, it is necessary to strictly and fully follow all the recommendations of specialists.

What does a doctor do

The main goal of surgical treatment is to remove the purulent focus, but this operation is not radical, i.e. cannot provide a complete cure. During the operation, the tissues are opened, a drainage is placed, with the help of which the purulent contents are removed. After the operation, antibiotic therapy is prescribed, drugs that will contribute to the overall strengthening of the body.

But still, we cannot exclude a recurrence of the pathology, which is far from rare. In order to prevent relapse, it is necessary to perform a second operation, during which the fistula tract is excised and sutured. In the future, antibiotics and a complex of vitamins and minerals are also prescribed. The diet is changing to a more gentle one for the digestive tract.

Prevention

Preventive measures are reduced to eliminating all provoking and traumatic factors. Even when hemorrhoids or anal fissures form, it is necessary to take all necessary measures to cure them as quickly as possible.

And caring parents will find on the service pages complete information about the symptoms of acute paraproctitis in children. How do the signs of the disease in children aged 1, 2 and 3 differ from the manifestations of the disease in children aged 4, 5, 6 and 7? What is the best way to treat acute paraproctitis in children?

Take care of the health of your loved ones and stay in good shape!

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A child over 2-3 years old can already tell his parents what worries him and where it hurts. With infants in their first year of life, parents have to be on guard all the time, because the baby cannot talk about his well-being and expresses any discomfort by crying and whims. Thus, the first signs of paraproctitis in infants may be tearfulness and restless behavior caused by severe pain in the anus. What are the causes of paraproctitis in children, how to recognize this disease and what methods are used to treat it, read the article.

Paraproctitis in childhood: main features

Paraproctitis is an inflammatory process affecting the tissue of the peri-rectal region. In most cases, this diagnosis is made to adult patients; men aged 20-50 years are in the high-risk group. But this pathology also occurs in infants, although much less frequently.

As a rule, children of the first year of life get paraproctitis, less often - children aged 1-5 years. Among sick children of all ages, infants under 6 months of age account for about 60% of patients, and infants aged six months to a year account for another 20%. According to statistics, the disease is diagnosed in boys much more often than in girls - in almost 95% of cases.

Paraproctitis in infants can occur either acutely or become chronic. The acute form of the disease is observed in approximately 70% of all cases. It begins with damage to the anal crypt or gland; the pathological process develops slowly. The trigger for its onset is a violation of the integrity of the mucous membrane of the rectum or stagnation of feces in it. Because of this, a retention growth is formed, damage to which leads to infection of the fatty tissue in the anal sphincter area.

Note: in childhood, infection occurs due to the activity of staphylococci, while in adult patients the causative agent of the disease is often E. coli.

Infected tissue is separated from healthy tissue, and an abscess is formed. In the future, if treatment is not carried out on time, the abscess may spontaneously open with the formation of a fistulous tract on the surface of the skin or into the subcutaneous tissue. When a fistula forms, the pain subsides, but this does not indicate recovery. This is how the process enters the chronic stage of development.

Depending on the location of the abscess, the following types of disease are distinguished:

• subcutaneous;
• retrorectal;
• ischiorectal;
• pelvic-rectal;
• submucosal.

Among them, children under one year of age are more often diagnosed with acute subcutaneous paraproctitis. Other types of the disease occur in isolated cases.

What are the causes of paraproctitis in children?

Paraproctitis in newborns can develop due to irritation and damage to the skin around the anus, in particular, diaper rash under the diaper. In addition, other diseases and external factors can provoke the disease:

• poor hygiene, improper child care;
• the presence of infection in the gastrointestinal tract;
• dysbacteriosis of intestinal microflora;
• low level of immunity;
• bowel irregularities, frequent constipation or diarrhea;
• congenital pathologies of the rectum;
• inflammatory diseases of the rectum;
• injury to the rectum or skin around the anus;
• pathology of the anal glands.

In small children, the anal glands may have an abnormal structure of the ducts (they are more branched than in adults and have additional channels). In this regard, the risk of infection increases when conditions favorable for this are created.

How to recognize the development of the disease in a child?

Parents of small children, especially infants in their first year of life, should know the symptoms of the disease. This will allow you to detect the disease at an early stage of development and, with minimal risk to the baby’s health, consult a doctor for treatment. The following symptoms indicate acute paraproctitis in children:

• increased body temperature;
• general deterioration of health;
• moodiness, crying for no apparent reason;
• increased crying when trying to defecate;
• redness, thickening in the anus;
• decreased appetite.

In children who can already walk, parents may notice a change in their gait - the baby involuntarily spreads his legs wide, since in this position he experiences less discomfort. Children who can already talk will complain of pain in the anus. Pain can occur not only during bowel movements, but also during urination. When you feel the anus, the pain intensifies. There may be pus in the stool (if the abscess has opened).

The intensity of symptoms depends on the stage of development and form of the pathological process, as well as on the individual pain threshold of the child. Thus, it is most difficult to diagnose the pelvic-rectal form of the pathology, since with it the inflammatory process occurs inside the small pelvis and is manifested by general malaise and fever.

With a significant increase in body temperature, signs of intoxication of the body may be added to the above symptoms. The child generally looks weak, lethargic, refuses to eat, and cries. Stool disturbances (both diarrhea and constipation) are also possible.

With the development of a chronic form of pathology, a fistulous tract in the anal area will be detected in the child. It may ooze pus. Temporary spontaneous closure of the fistula is possible; in this case, an abscess will form, indicating an exacerbation of the chronic form of the disease.

Danger of pathology

The seriousness of the disease cannot be underestimated. Without treatment, the disease will not go away, so seeing a doctor is a must. The sooner medical assistance is received, the lower the likelihood of complications developing.

Important! Under no circumstances should you try to open an abscess yourself! This can lead to the spread of infection to nearby healthy tissue and the development of life-threatening complications.

Possible complications include:

• infection of the urinary and reproductive systems located near the abscess (prostate, uterus, ovaries, ureters, bladder);
• breakthrough of the abscess and spread of pus into the pelvic cavity (if a fistula forms not on the surface of the skin, it is much more difficult to eliminate it).

Methods of treating the disease

When paraproctitis develops, treatment most often involves surgical intervention. Conservative treatment is carried out in rare cases and only if an abscess is detected at an early stage of the disease. This method is not always effective, unlike surgery, which allows for complete recovery.

For conservative therapy, baths, suppositories, and ointments with anti-inflammatory and antiseptic effects can be used. To facilitate the process of defecation, microenemas are used. Antibiotic therapy is prescribed.

Surgery

An endoscope is used during the operation. Under general anesthesia, the abscess is opened and the fistula tract and affected tissue are excised. After removing the pus, the wound is drained. In the postoperative period, antibiotics are prescribed, and the operated area is treated with antiseptic. Surgery is considered the most effective method of treating the disease.

Measures to prevent paraproctitis in children

Everyone knows that preventing a disease is easier than treating it, and given the need for surgical intervention to eliminate the pathology, every parent needs to know and follow measures to prevent paraproctitis in children:

• parents should monitor the baby's stool and the regularity of bowel movements;
• skin care in the anal area should be constant to prevent irritation and microcracks on it;
• it is important to ensure that there is no mechanical injury to the skin around the anus or rectal mucosa;
• After each act of defecation, it is imperative to wash the child;
• a special role is played by the prevention and timely treatment of intestinal infections in children;
• parents should improve the child’s immunity: harden him, monitor his diet, exercise with him;
• In order to prevent various diseases, the child should be regularly shown to the pediatrician.

Paraproctitis is a disease that poses a threat to the life and health of a child. Ignoring its symptoms is unsafe and unwise. If signs of an inflammatory process are detected, you should consult a doctor as soon as possible.

Paraproctitis in children is one of the most common diseases. This is a purulent inflammation of the rectum that occurs at any age. The process is provoked by pyogenic microbes that have penetrated the cellular spaces of the intestine. The main difference between paraproctitis and hemorrhoids is the suppuration of the nodes, which contributes to the spread of infection throughout the body.

Why does paraproctitis develop?

The paraproctitis incidence group includes children under 14 years of age. But most often, intestinal inflammation worries newborns and children under one year of age. The main cause of tract damage is infection of the subcutaneous tissue with staphylococcus. The location of the fiber is the lower part of the rectum. The underdeveloped ducts of the anal glands are equipped with branches and canals.

Within them, favorable conditions are created for the development of inflammation:

1. frequent bowel movements, characteristic of newborns;
2. constipation - difficulty passing stool, which often bothers infants;
3. wearing tight, chafing underwear or uncomfortable diapers, which injure the anal area and contribute to the formation of abrasions and cracks.

Signs of exacerbation and chronicity of the process

The development of acute paraproctitis manifests itself through the child’s poor health, whims, refusal to eat and a jump in temperature to high levels. In infants, a sign of inflammation in the anus may be crying during bowel movements. Older children talk about pain in the anus. A visual symptom of paraproctitis is a thick, hot and reddened area near the anus. When feeling the node, the baby reacts to pain.

The submucosal type of paraproctitis in “artificial” babies and infants is sometimes asymptomatic. Only a temperature that periodically rises to 37.5°C helps to suspect a deviation. With a deep location of the defect, symptoms increase gradually. First, the temperature rises and your health worsens. Primary pain during defecation also increases gradually.

When the process becomes chronic, a fistula tract is formed. According to the location criterion, fistulas are divided into three types:

• full, opening into the rectum and onto the skin;
• incompletely closed, open into the rectum and resting on fatty tissue;
• incomplete open, extending onto the skin without contact with the rectum.

In most cases, fistulas in infants are a congenital defect. After intestinal infection, incomplete fistulas transform into complete ones.

An early sign of a chronic form of paraproctitis in newborns is a fistulous tract. During periods of exacerbation, symptoms are milder than before the process became chronic. Exacerbations occur frequently, but the fistula can close indefinitely.

Diagnosis of different forms of paraproctitis

If there are first signs of paraproctitis, a sick child should be shown to a proctologist. During the examination, the specialist will see swelling and hardening of the anal area, establish a discrepancy in the size of the buttocks, or notice smoothness of the folds of the mucous tissue of the anus. Rectal examination reveals an abscess in the outer or deep layers of the pelvis. The technique allows you to determine the size and location of the abscess.

Blood test results show increased white blood cell levels and accelerated ESR. The data confirms bacterial infection of the child’s body. Ultrasound helps verify the correctness of the preliminary diagnosis.

Advanced paraproctitis in tiny newborns is diagnosed by external signs and a collected medical history. Rectal digital examination reveals an abscess or fistulous tract. The location of the defective area and its relationship to the sphincter and rectum are determined by the responses of ultrasound, probing and fistulography.

A child has developed paraproctitis: what to do?

The method of treating a small patient for paraproctitis is selected taking into account the form of the pathology. In case of exacerbation, the child is referred for surgery. Surgeons open and drain the abscess and excise the affected crypt and gland. The prognosis for emergency intervention is favorable.

A protracted form of paraproctitis in an infant is treated conservatively and surgically. For successful healing of the fistula tract, therapeutic measures are aimed at preventing infection:

1. careful care of the delicate skin of the anus;
2. timely cleansing of the anus from fecal residues;
3. bathing in a weak solution of potassium permanganate;
4. sitz baths with manganese (the solution should have a pale pink color).

After the inflammation has been relieved, treatment is continued with antibiotics, ichthyol ointment, suppositories, Levomekol and Vishnevsky's liniment. Surgical intervention is postponed until the fistula is completely formed. This process takes about 2 years. Surgical assistance is provided in the form of removal of the defect and scar tissue. Another option is to eliminate scars, intersect and ligate the fistula tract. The event guarantees a complete recovery.