I. Diagnosis
1.Symptoms
(1) Most of them have an acute onset.
(2) Painful swelling around the anus and rectum, and pus flowing after rupture.
(3) May be accompanied by systemic infectious symptoms such as chills and fever, headache, fatigue, loss of appetite, etc.
(4) It may be accompanied by difficulty in passing stool and urine.
2.Signs
(1) Visual diagnosis of perianal redness and swelling, with lumps above the skin surface.
(2) Finger diagnosis of anorectal local burning, tenderness or pressure pain, fluctuating sensation or hard lump, or rectal mucous membrane fullness, anal temperature higher than normal.
(3) Anal speculum examination to observe whether there are endogastric, pus and blood and other lesions in the rectum.
3.Auxiliary examination
(1) Routine blood count Leukocyte and neutrophil counts are elevated.
(2) puncture and pus extraction, bacterial culture, antibiotic sensitivity test should be performed, suspicion of tuberculosis infection pus smear to find antacid bacilli, can clarify the causative agent and guide the use of drug treatment.
4.Differential diagnosis
(1) Perianal folliculitis and boils
They are usually found in the subcutaneous area around the anus, and will not form anal fistula after rupture because they are not pathologically related to the anal saphenous fossa.
(2) Paranal sebaceous cyst
A paranal mass without skin erythema and pressure pain, with a smooth rounded surface and clear margins, without systemic symptoms. The cyst may also become red, swollen and painful after infection, but will not form an anal fistula after rupture.
II. Treatment
General treatment principles.
Anti-infection treatment is the main treatment when pus has not formed, supplemented by topical application of traditional Chinese medicine. Once the abscess is formed, it should be incised and drained in time to prevent the infection from spreading to the deeper and surrounding tissues.