Two stages of treatment
A pararectal cyst can exist asymptomatically for years and appear only when it suppurates - then the clinical picture resembles acute paraproctitis. The first step is an autopsy: the pus is evacuated, the cavity is drained, and acute inflammation subsides. However, the cyst itself with its shell remains intact and, without radical removal, festers again. Therefore, 1-2 months after the inflammation subsides, the second stage is planned - excision of the entire cyst with a capsule and mandatory histological examination.
The purulent process does not wait
Acute paraproctitis is a purulent inflammation of the tissue around the rectum. It is manifested by increasing throbbing pain, swelling, redness and high temperature. This is an emergency condition: pus spreads through the cellular spaces, and a delay of several days turns a limited abscess into an extensive phlegmon.
Antibiotics do not work here without opening: they cannot penetrate the cavity delimited by a purulent capsule. The only effective approach is opening and drainage.
Basic conditions
- acute paraproctitis - an abscess in the perirectal tissue
- suppurating pararectal cyst - inflammation of a pre-existing cystic formation
- suppurating epithelial-coccygeal tract - inflammation of the congenital canal in the intergluteal fold
- suppurating epithelial-coccygeal cyst - a cavitary form of the same process
- boil - purulent inflammation of the hair follicle
What happens after opening
An autopsy relieves the acute condition: pain and fever go away within 24 hours. However, with paraproctitis and the coccygeal tract, after healing, a fistula often forms, requiring planned radical intervention in 1–3 months. The patient is warned about this in advance - this is not a complication, but a natural stage in the course of the disease.