Experts from the Nanjing Armed Police Hospital's Anorectal Center introduce that perianal abscesses are common anorectal diseases. They are also the acute phase of the inflammatory pathological process of the anus and rectum, while anal fistulas represent the chronic phase. Common pathogenic bacteria include E. coli, Staphylococcus aureus, Streptococcus, and Pseudomonas aeruginosa. Occasionally, anaerobic bacteria and Mycobacterium tuberculosis may be involved, often resulting from mixed infections by various bacteria. Recent findings have also shown a correlation with injuries along the anal line. The most common type is the subcutaneous abscess around the anus, which is often caused by the spread of anal gland infections outward through the subcutaneous part of the external sphincter or directly outward.
**Traditional Chinese Medical Treatment for Perianal Abscess:**
1. **Actual Syndrome Anal Abscess:** Symptoms include internal damp-heat accumulation and toxicity. Manifestations include obvious redness, swelling, heat, and pain in the anal area, constipation, short and red urine, red tongue with yellow greasy coating, and rapid pulse.
- **Treatment Method:** Clear heat, detoxify, and remove dampness.
- **Prescription:** 30g of Viola philippica, 30g of Dandelion, 15g of Honeysuckle, 12g of Red Peony, 12g of Scutellaria baicalensis, 10g of Wild Chrysanthemum, and 10g of Skullcap.
2. **Deficiency Syndrome Anal Abscess:** Symptoms include internal heat due to yin deficiency and damp-heat accumulation, causing anal itching. Manifestations include no change in skin color around the anus, unclear boundaries, slight elevation or no elevation, thin white pus, general fatigue, low-grade fever, red tongue with greasy coating, and fine pulse.
- **Treatment Method:** Nourish yin, clear heat, and remove dampness.
- **Prescription:** 9g of Angelica sinensis, 9g of Phellodendron, 10g of White Peony, 10g of Rehmannia glutinosa, 10g of Lycium barbarum, 10g of Artemisia annua, 10g of Adenophora stricta, 10g of Ophiopogon japonicus, and 10g of Asparagus cochinchinensis.
**Usage:** Decoction taken in three doses daily.
**Western Medical Treatment for Perianal Abscess:**
A small number of perianal abscesses can be resolved with antibiotics, hot water sitz baths, and local physiotherapy. However, most require surgical treatment. There are two types of surgery:
1. **Treatment for Simple Abscesses:** Under lithotomy position or lateral decubitus, using local or spinal anesthesia, a radial incision is made at the abscess site to release the pus. A finger is inserted to probe the size of the abscess cavity and separate its partitions. If necessary, a small amount of skin at the edge of the incision is cut to facilitate drainage. Finally, gauze impregnated with petroleum jelly is placed into the abscess cavity for drainage.
2. **Abscess Communicating with Fistula:** After incising the abscess, a probe is carefully used to check the internal opening, then the fistula is cut open, appropriately removing some skin and subcutaneous tissue. Surrounding tissues around the internal opening are also slightly removed to ensure smooth drainage. If the internal opening is deep and the fistula passes through the anal sphincter, the thread therapy method can be adopted. The advantage of these surgeries is that they can cure the abscess in one stage without forming an anal fistula. However, if it is difficult to find the internal opening during acute inflammation, blind searching should be avoided to prevent the spread of inflammation or the formation of false channels. In such cases, only incision and drainage are performed, followed by fistula surgery after the formation of an anal fistula. The advantage of this second-stage surgery is high accuracy and cure rate.
Experts from the Nanjing Armed Police Hospital's Anorectal Center point out that perianal abscesses can be treated with the above methods, but if improperly managed, they can lead to anal fistulas requiring surgical treatment. Currently, the best surgical treatment for anal fistulas is the HCPT minimally invasive technique, which is favored by many patients for its painlessness, safety, and lack of postoperative recurrence.
Special Reports: [Hemorrhoids], [Anal Fistula], [Anal Fissure], [Rectal Bleeding], [Perianal Itching], [Perianal Cyst]
[Nanjing Armed Police Hospital Anorectal Center] http://www.jsgcw.com
[Nanjing Armed Police Hospital Anorectal Center] http://www.njgcyy.net
[Nanjing Armed Police Hospital Anorectal Center] http://www.jswjyy.com
[Nanjing Armed Police Hospital Anorectal Center] http://www.wjgc.net
Consultation Phone: 025-85500079 Consultation QQ: 997287111
Hospital Address: No. 256 Heyan Road, Nanjing (100 meters to the right of the North Gate of Hongshan Zoo)
Transportation: Get off at Hongshan Zoo Station on Subway Line 1; take buses 30, 8, 64, 54, 72, 77, Yuge Line, or Nanzhou Line and get off at Dongjinting Station.
[Yangzhou Armed Police Hospital Anorectal Center] http://www.yzwjyy.com
Consultation Phone: 0514-87218120 Consultation QQ: 997287111
Hospital Address: No. 8 Jiangdu South Road, Yangzhou, Jiangsu Province
Transportation: Take buses 4, 19, 25, 26, 26 Late Night, 66, 66 Late Night, 101, 102, 201, 208, 209 in Yangzhou City and get off at Armed Police Hospital Station.
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