The improving of efficiency diagnostics and surgical treatment of patients with acute paraproctitis

Authors

  • I. M. Shevchuk Ivano-Frankivsk National Medical University
  • O. V. Novytsky Ivano-Frankivsk National Medical University
  • A. L. Shapoval Ivano-Frankivsk National Medical University
  • I. Ya. Sadovyi Ivano-Frankivsk National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2020.2.10766

Keywords:

acute paraproctitis, ultrasonography, magnetic-resonance tomography, surgical treatment

Abstract

The aim of the work: to analyze the effectiveness of ultrasonography and magnetic resonance imaging in the diagnosis of deep forms of acute paraproctitis and evaluate the results of surgical treatment of these patients.

Materials and Methods. The results of surgical treatment of 285 patients with various forms of acute paraproctitis were analyzed. Among them – 184 (64.6 %) men, 101 (35.4 %) women. The age of patients ranged from 19 to 77 years. Subcutaneus- submucosal form of acute paraproctitis was diagnosed in 173 (60.7 %) patients and in 112 (39.3 %) – deep forms (ischiorectal, pelviorectal and retrorectal). Long-term results of treatment in patients with deep forms of acute paraproctitis were analyzed in terms of 3 months to 2 years with the help of proctological examination, additional instrumental methods of diagnosis, taking into account the number of relapses, the transition to the chronic form (formation of pararectal fistula) and evaluation functional results, in particular, insufficiency of the anal sphincter.

Results and Discussion. The results of the use of ultrasonography and magnetic-resonance imaging in the diagnosis of deep forms of acute paraproctitis in 57 patients were analyzed. The diagnostic value of ultrasonography was analyzed in 42 (73.7 %) patients. Ultrasonography using a transdermal convex sensor was performed in 35 (83.3 %) patients, endorectal sensor in 7 (16.7 %) patients. Magnetic-resonance imaging with contrast of the rectum was performed in 12 (10.7 %) patients with deep forms of acute paraproctitis and in three patients without contrasting the rectum, whom ultrasonography had not previously allowed to establish purulent foci in pararectal cellulose. Long-term results of treatment up to two years were studied in 65 patients with deep forms of acute paraproctitis. Insufficiency of anal sphincter of degree II was found in three (2.7 %) patients, degree III – in one patient. Disease recurrence occurred in 7 (6.25 %) patients, pararectal fistula was formed in 8 (7.1 %) patients.

References

An, V.K., & Rivkin, V.L. (2003). Neotlozhnaya proktologiya [Emergency proctology]. Moscow: ID Med. praktika [in Russian].

Trunin, E.M., Begishev, O.B., & Loyt, A.A. (2006). Glubo­kie paraproktity v ekstrennoy meditsine [Deep paraproctitis in emergency medicine]. Ambulatornaya khirurgiya. Statsionar zameshchayushchie tekhnologii – Ambulatory Surgery. Hospital Repla­cing Technology, 3 (23), 48-51 [in Russian].

Kondratenko, P.G., Gubergrits, N.B., Elin, F.E., & Smirnov, N.L. (2006). Klinicheskaya koloproktologiya: rukovodstvo dlya vrachey [Clinical сoloproctology: A guide for doctors]. Kharkiv: Fakt [in Ukrainian].

Militsa, N.N., Toropov, Yu.D., & Kozlov, V.B. (2008). Lechenie ostrogo paraproktita [Treatment of acute paraproctitis]. Klіnіchna khіrurhіia – Clinical Surgery, 10, 37-39 [in Ukrainian].

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Published

2020-01-21

How to Cite

Shevchuk, I. M., Novytsky, O. V., Shapoval, A. L., & Sadovyi, I. Y. (2020). The improving of efficiency diagnostics and surgical treatment of patients with acute paraproctitis. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 59–62. https://doi.org/10.11603/2414-4533.2020.2.10766

Issue

No. 2 (2020)

Section

EXPERIENCE OF WORK

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