2023 Author: Priscilla Miln | [email protected]. Last modified: 2023-08-25 02:58
Most often, paraproctitis is diagnosed in children under one year old. The disease is associated with painful symptoms and unpleasant consequences. Therefore, it cannot be ignored. Parents need to know which signs to look out for first.
Paraproctitis is an inflammatory phenomenon that spreads to tissues in the area of the rectum. This organ is surrounded by several peculiar spaces: ileo-rectal, posterior-rectal, pelvic-rectal and submucosal. The inflammatory process can occur in any of them. When an infection penetrates into the adipose tissue localized in the rectum, it is separated from he althy areas. This is the beginning of the development of an abscess. With timely treatment, inflammation can be stopped. Otherwise, the abscess is opened, a kind of fistulous passage appears. In such a situation, the disease becomes chronic.
Among children, pathology most often occurs before 6 months (70% ofall cases). It is rarely diagnosed in older children. According to statistics, inflammation of the tissues around the rectum usually occurs in boys, which is associated with structural features of the organs of the genitourinary system.
The main cause of paraproctitis in children under one year old is infection. In infants, especially those on breastfeeding, inflammation is caused by staphylococci. Also, pathogenic flora can enter the rectum in the following cases:
- neglect of hygiene rules when caring for a newborn;
- frequent stool disorders, accompanied by the formation of cracks around the anus;
- congenital diseases of the rectum;
- inflammation of the rectal mucosa due to lactose intolerance.
Thus, paraproctitis occurs when an infection enters the body. To activate the pathogenic flora, predisposing factors are needed. For example, anal fissures appear with poor hygiene. After washing, diapers are put on the baby, and diaper rash, left unattended, appears under them.
Symptoms of the acute form of the disease
The most characteristic are the symptoms of paraproctitis in children under one year old at the acute stage of development. In this case, parents note in the baby:
- temperature increase to 39 degrees;
- appearance of causeless moodiness;
- refusing food;
- defecation is accompanied by strongcrying.
Painful discomfort in the child persists even in a sitting position. As a result, this leads to flatulence and stool retention. When visually examining the anus, you can notice reddening of the skin, nodular neoplasms. When pressed, the child begins to cry violently.
If the treatment of paraproctitis in children under one year old is not carried out in a timely manner, the abscess may spontaneously open outwards or into the subcutaneous tissue. After that, the condition of a small patient usually improves: the temperature drops, the pain subsides or disappears altogether. At the same time, discharge with impurities of pus and blood may begin to come out of the anus.
Often, with spontaneous opening of an abscess, a fistulous tract is formed. The disease becomes chronic. The consequences may be the following he alth problems:
- melting by the contents of the neoplasm of the inner layer of the rectum (in girls, the vagina may suffer);
- spread of infection throughout the body;
- breakthrough of an abscess into the abdominal cavity, as a result, the development of peritonitis.
Fistulas are sometimes congenital. In the acute course of paraproctitis, they increase, turn into hollow. In this case, there is a pronounced asymmetry of the buttocks.
What should parents be concerned about?
The first signs of paraproctitis in children under one year old appear at the end of the first day of the development of the disease. On the second or third day, possible purulent discharge from the formation ordirectly anus. At the same time, in the process of defecation, along with the feces, a large amount of mucus comes out, which promotes tissue healing.
The subcutaneous form of the disease is easy to diagnose by external signs. The submucosal variant is accompanied by only a slight increase in temperature, which is often perceived by parents as a decrease in immunity or teething. Therefore, they do not immediately seek help from a doctor. This is dangerous with a breakthrough of the abscess and the development of sepsis. In this case, the temperature rises to 40 degrees. The child's heart rate increases, vomiting appears. Urgent medical attention required. If these symptoms appear, parents should call an ambulance.
Diagnosis of paraproctitis is carried out in 2 stages. First, the doctor examines the history of the small patient and conducts a physical examination. Suspicion of the disease may arise in the presence of swelling or pain in the area of the anus.
To confirm a preliminary diagnosis, a comprehensive examination is required. It usually includes the following activities:
- finger examination;
- rectal probing;
- Ultrasound of the rectum;
- blood, urine tests.
If a child has pus from the anus, the biological material is sent for culture. With the help of this analysis, it is possible to establish the causative agent of the disease for the appointment of antibiotic therapy later.
Features of therapy
According to medical reviews, the treatment of paraproctitis in children under one year old in acute form is carried out exclusively through surgical intervention. The operation is performed on the day of visiting a doctor, as there is a risk of infection spreading throughout the body in the event of a breakthrough of the neoplasm into the intestine. The intervention is performed using general anesthesia. It lasts no more than 20 minutes. In the presence of a fistula, the operation is performed in 2 stages:
- The neoplasm is opened, cleaned of purulent secretions, washed and drained. In order to prevent infection, small patients are prescribed antibiotics. Duration of admission is 7 days.
- When the child's condition improves after 3-4 days, the drainage is removed. After the first bowel movement, daily baths using a manganese solution are shown.
For three days after the intervention, a non-slag diet is applied. Additionally, physiotherapy can be prescribed on an individual basis. The child is usually discharged 2 weeks after the operation. At home, treatment with the use of drugs restoring the intestinal microflora continues for some time.
The chronic form of the disease provides for conservative therapy (antibacterial drugs, anti-inflammatory suppositories, Levomekol). If such methods are ineffective, which most often happens, surgical treatment of paraproctitis in a child is prescribed. An operation is usually performed at 1 year or even 2 years, in the absence of a clear threat, intervention is notrecommended.
Doctor Komarovsky's advice
The well-known pediatrician Komarovsky believes that the only true way to treat the disease is surgery. After the intervention, it is important to adhere to the elementary rules of hygiene with special responsibility. This will help prevent relapses.
In addition, with paraproctitis in children under one year old, Komarovsky advises using any glycerin suppositories to ease the stool. The doctor does not recommend self-medication, and when the first signs of illness appear, immediately contact a pediatrician.
Prognosis for recovery
Paraproctitis in children under one year does not belong to the category of deadly diseases. With timely detection, it can be completely cured.
If the inflammatory process was detected late or complications appeared, the duration of therapy can be increased several times. Surgical intervention helps to stop the consequences of the disease. The prognosis is positive even in this case.
An unfavorable outcome is possible with a chronic form of paraproctitis, an abscess rupture into the abdominal cavity.
To prevent paraproctitis in children after a year and in the first 12 months of life, it is necessary to follow basic hygiene rules and treat diseases associated with intestinal disorders in a timely manner. If a child is prone to constipation or diarrhea, the problem should not be left unattended. The appearance of pain during defecation requiresSeek immediate medical attention.
An advanced form of the disease can cause not only unpleasant symptoms, but also surgical intervention. This is additional stress for an immature organism.
Prevention of paraproctitis includes the following recommendations:
- Prevention of constipation and diarrhea. To do this, you need to establish nutrition and do not forget about the drinking regimen.
- Compliance with the rules of personal hygiene from the first hours of a child's life. It is necessary to wash the baby after each act of defecation, periodically arrange air baths. When diaper rash occurs, you need to use special creams.
- Timely treatment of intestinal disorders under the guidance of a pediatrician.
- Strengthening immunity. Hardening, daily walks in the fresh air, establishing the correct diet and sleep - all this has a positive effect on the work of the body's defenses.
In the photo, paraproctitis in children under one year old looks quite unpleasant. Therefore, the parents themselves should examine the baby daily for redness in the anus. If specific signs of illness appear, you should immediately contact your pediatrician.
Reviews of paraproctitis in a child up to a year from the parents are varied. Most moms and dads talk about a sudden rise in temperature, followed by reddening of the skin around the anus. In the process of defecation, the child constantly cried. Only medical examinationhelped them understand the root cause of these symptoms.
Parents also say that only surgery made it possible to get rid of the disease. However, the dressings and treatment of the affected area that follow it are quite exhausting. Even after removal of the neoplasm, children may still be capricious for some time, since the rehabilitation process is often accompanied by a slight pain syndrome.
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