Anal secretions

Introduction Anal sinusitis anal microscopic examination showed obvious congestion, edema and deepening of the crypt, and more anal secretions. Anal sinusitis (anal sinusitis), also known as anal cryptitis, is an inflammatory lesion in the anal sinus and anal gland. It is an important potential infection, and approximately 85% of anorectal lesions are associated with anal sinus infection. The patient showed slight pain in the anus, swelling, anal gland secretion, dry anal canal, poor bowel movements; or burning pain in the anal canal during defecation, or radioactive pain in the perineum, the possibility of anal sinusitis should be considered. If the anus is formed by the growth of connective tissue of varying sizes in the anus, or with the incarceration of the prolapse, it may be an anal papillitis.

Cause

Causes:

Infection and injury

The anal sinus is in the lower part of the sinus, the opening is upward, and it is in the shape of a bag. The drainage is poor. It is easy to store the feces and cause infection and injury. The edge of the anal sinus has a free half-moon anal flap, which is also vulnerable to scratching of dry feces. Teared when defeated. Increased frequency of bowel movements or intestinal inflammation, dysentery, diarrhea, constipation, etc., frequently stimulate the anal sinus and anal flap. Physical and local resistance is reduced, or there are chronic wasting diseases, feces and foreign bodies accumulate in the anal sinus, the sinus is blocked, the anal fluid secreted by the anal gland is not drained, and the feces are decomposed, the bacteria multiply, and the anal sinus is Inflamed and swollen. Common pathogens include Escherichia coli, Staphylococcus, Proteus, Aerobacter, Streptococcus, Mycobacterium tuberculosis, Pseudomonas aeruginosa, etc., of which Escherichia coli accounts for 60% to 70%.

2. The effects of sex hormones

Like sebaceous glands, the development and function of anal glands are mainly regulated by human sex hormones. The level of sex hormones directly affects the proliferation and atrophy of anal glands. Therefore, the level of sex hormones is closely related to the occurrence of anal sinusitis. And sex hormones have the greatest effect on androgens. In a person's life, the mother's body brings more androgen than the mother, so the perianal infection is more, once developed into a long-term, with the level of androgen decreased, and the perianal infection can be self-healing. Men and young adults have higher levels of androgen, so anal gland infections increase, and perianal abscesses often occur in young adults. The level of senile sex hormones decreased significantly, and the anal glands atrophied. Therefore, anal sinusitis and perianal infection rarely occur in the elderly.

3. The impact of embryonic development

It is believed that in the 7th week of embryonic development, the cloaca and anal membrane rupture and fuse with the hindgut. At this time, the dorsal part of the cloaca is derived from the anal canal, the dentate line and the lower part of the anal column. If for some reason, the anus is caused. Abnormal fusion between the membrane and the hindgut, can not form normal dentate lines and crypts, and form irregular dentate lines and deep crypts, susceptible to bacterial infection and injury after birth, forming anal sinusitis, perianal abscess And anal fistula. Clinical observation confirmed that the anal crypts of patients with perianal abscess and anal fistula are often abnormally deepened, which can be as deep as 3 to 10 mm, and the number can be increased to 3 to 13. The theory that embryonic development affects the anal sinus has been widely recognized by experts.

an examination

Related inspection

Anal finger examination anal inspection

Clinical manifestation

Mild pain in the anus, swelling of the anal gland, dry anal canal, poor bowel movements; or burning pain in the anal canal during defecation, or radioactive pain in the perineum, the possibility of anal sinusitis should be thought of. If the anus is formed by the growth of connective tissue of varying sizes in the anus, or with the incarceration of the prolapse, it may be an anal papillitis.

2. Anal microscopy

Anal sinusitis see obvious crypts congestion, edema and deepening, anal endocrine or more pus and blood; anal papillitis see anal flap, anal papilla redness, triangular, arched, papillary growth, anal sinus purulent or Puseptic secretions can be diagnosed.

Differential diagnosis

Differential diagnosis of anal endocrine:

1, anal fissure: anal fissure with anal periodic pain, constipation, stool with blood as the main symptom. The pain is heavier than the anal crypt and the pain is longer.

2, perianal abscess: is the result of further development of anal cryptitis, mainly manifested as perianal pain, gradually aggravated, chicken pain when pus, with aversion to cold fever embolism, blood routine examination of white blood cells increased significantly, in the middle The granulocytes are also elevated.

3, anal perineal area wet and dirty: old incontinence or anal incontinence refers to defecation and exhaustion that are not controlled at least 2 times a day or more. It is a kind of clinical symptom with various pathophysiological basis caused by various reasons. The incidence rate of the elderly is about 1%. The elderly inpatients are more common than the average female. Fecal incontinence is common in elderly people with mild fecal incontinence and is often not reported by patients and doctors. Physical examination showed that the perineal perineal area was wet and unclean.

4, inflammatory external hemorrhoids: inflammatory external hemorrhoids caused by inflammation of the connective tissue outside the sputum, varicose external hemorrhoids, can also be seen in the acute inflammatory phase of thrombosis. There is swelling, congestion, and pain in the anal tissue, and the patient's walking activity is limited.

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