Subscribe
165
Chen Tian Jing
Colorectal Surgery
About me
Master's degree, specializing in research and treatment of colorectal surgery.
Proficient in diseases
Mixed hemorrhoids, internal hemorrhoids, external hemorrhoids, anal papillitis, perianal abscess, anal fistula, anal sinusitis, anal fissure, perianal abscess, pruritus ani.
Voices
Does a perianal abscess require hospitalization?
Perianal abscess is a common acute onset disease in proctology. If surgery is performed for a perianal abscess, it is recommended that the patient be hospitalized. Hospitalization observation is mainly for the local wound, to prevent recurrence and infection, and to ensure early proper wound dressing and drainage work, laying a good foundation for granulation growth post-surgery. The general hospitalization duration is about one week to ten days. In some cases, where the symptoms are severe or the abscess cavity is large, the hospital stay may extend to 20 days. During hospitalization, it is necessary for a professional proctologist to disinfect and change dressings of the local wound, and it is important to wash with saline water after each bowel movement.
Symptoms of cancerous transformation in anal fistula
The vast majority of anal fistulas do not undergo malignant transformation. However, there is a possibility of cancerous changes if an anal fistula that has repeatedly recurred over a long period is not treated aggressively, or if the inflammation of the fistula tract is severe. When an anal fistula undergoes malignant transformation, the secretion from the local fistula tract increases and is accompanied by a foul smell, and there may even be ulceration of the local fistula tract mucosa. Further surgical procedures, such as fistulotomy with seton placement, are required, and the excised fistula tract suspected of high-grade malignant transformation should be sent for pathological examination. If malignant transformation is confirmed, further pelvic MRI examinations are necessary to determine whether there is local and surrounding lymph node metastasis.
Can external hemorrhoids be cured completely?
External hemorrhoids are a common clinical type of hemorrhoids, and the main method for radical treatment is primarily surgical removal. The sole use of topical medications or oral medications can only alleviate the congestion, swelling, and pain caused by external hemorrhoids, but cannot completely remove them. The surgical methods for external hemorrhoids primarily include external hemorrhoidectomy or the combined internal ligation and external excision surgery. If internal hemorrhoids are also removed during the surgery, there will be sutures present, and it is recommended that patients be hospitalized and observed until the sutures fall out before being discharged. This is to avoid complications such as major bleeding from premature suture loss due to early discharge or exertion.
How to drain pus when a perianal abscess bursts?
If an anal abscess ruptures, it then forms an anal fistula. Both the acute phase of an anal abscess and anal fistula require surgical treatment. If only the local pus is drained, it is generally recommended to open the abscess cavity for local debridement and disinfection, and to further excise the infection focus. During surgery, to protect the function of the local anal sphincter, a seton stitch procedure is also needed. Post-surgery, it is necessary to disinfect and change dressings for the local wound, and ensure normal growth of the granulation tissue to prevent the occurrence of false healing.
Is anal pain and rectal bleeding indicative of rectal cancer?
Pain in the anal area, accompanied by blood in the stool, does not necessarily indicate rectal cancer. There are many causes of pain and bloody stools, which require identification and diagnosis through the color of the bloody stools, digital rectal examination, and colonoscopy. Common causes of bright red bloody stools or pain are mainly due to hemorrhoids and anal fissures. During the onset of rectal cancer, early stages generally do not involve pain in the anal area. It is mainly characterized by changes in bowel habits, or dark red blood in the stool in the middle to late stages. The tumor may grow larger, causing difficulty in defecation, and may even induce systemic symptoms such as weight loss, anemia, and intestinal obstruction.
How to treat rectal prolapse?
Rectal prolapse mainly includes external rectal mucosal prolapse and internal rectal mucosal prolapse. External rectal mucosal prolapse primarily refers to the symptoms and types of clinical rectal prolapse. The most common and effective treatment for rectal prolapse or internal rectal mucosal prolapse is surgery. Simple medication can only relieve local relaxation or compressive symptoms, but it does not have a definitive therapeutic effect on the disease itself. The surgery mainly involves the removal and excision of the relaxed and prolapsed mucosa, thereby increasing the tightness of the intestinal mucosa and relieving the local mucosal pressure on the anus, which causes the patient's feelings of bloating and descent. After the surgery, patients need to rest in bed for a week and should avoid squatting and excessive abdominal straining in their future activities.
Why is a perianal abscess so painful?
During the acute phase of a perianal abscess, the intense pain is mainly due to the formation of an abscess and pus pockets in the subcutaneous area around the anus. The pus within these cavities cannot rupture, causing localized skin nerves to experience pecking-like or jumping pain. The pain from a perianal abscess is generally unbearable for patients, necessitating prompt surgical treatment. The surgical approach for a perianal abscess primarily involves incision and drainage, followed by debridement of the abscess cavity. It is important to note that postoperative disinfection and dressing changes of the local wound are crucial to prevent false healing of the wound.
What should be paid attention to for anal fistula?
Patients with anal fistula, as there is an external opening in the anal region and intermittent thick secretion from this opening, should first ensure to keep the perianal area clean. It is recommended to change underwear daily and to cleanse the area after bowel movements with saline or hemorrhoid wash, and to conduct fumigation and hot compresses around the perianal area and the external opening to prevent irritation and even sharp pain caused by residual feces and secretions. Furthermore, during acute episodes of anal fistula, mupirocin ointment can be applied around the external opening for anti-inflammatory treatment. The definitive surgery for anal fistula primarily involves fistulotomy with seton placement. Without surgery, an anal fistula cannot be completely cured and may lead to worsened conditions such as thickening of the fistula wall or increased branching of the fistula channels.
How many days is the hospital stay for perianal abscess surgery?
After surgery for a perianal abscess, due to the presence of a local wound and the significant discharge from the wound in the early postoperative period, combined with the potential fall of ligatures or elastic bands at the area, a hospital stay of approximately two weeks is required. For severe cases or those with deeper abscess cavities, a hospital stay of three weeks or even a month might be necessary. The main purpose of the hospital stay post-surgery is to monitor for any major bleeding from the wound, and to facilitate dressing changes. Postoperative dressing changes for a perianal abscess wound are crucial for recovery, as only thorough daily disinfection and dressing changes can ensure uniform granulation and growth of local tissues, prevent the enclosure of pus within the local cavity leading to pseudohealing or reinfection, and thus affect the treatment outcome of the surgery. Approximately one month after surgery, regular follow-up visits are required to monitor the healing of the local wound.
How to deal with a ruptured anal fistula?
The clinical symptoms of anal fistula mainly include intermittent discharge of pus from the external opening near the anus, or occasional acute attacks that cause redness, swelling, heat, and pain around the external opening of the anus. If the external opening of the anal fistula breaks and discharges pus, or is accompanied by pain, it is considered an acute phase of the anal fistula. The primary method of management and treatment is surgery, with the main surgical approach being fistulotomy and seton placement. To locally alleviate the inflammatory symptoms of the external opening of the anal fistula, anti-inflammatory ointments can be applied for temporary anti-inflammatory treatment. However, to avoid the local complications such as thickening or branching of the fistula, it is advised that patients undergo surgical treatment of the anal fistula as soon as possible. (Please use medication under the guidance of a professional physician, and do not self-medicate.)