نظرة عامة

الناسور الشرجي هو المصطلح الطبي للنفق المصاب والذي يظهر بين الجلد والفتحة العضلية في نهاية الجهاز الهضمي (فتحة الشرج).

معظم حالات الناسور الشرجي هي نتيجة للالتهابات التي تبدأ في الغدة الشرجية. وتتسبب هذه الالتهابات في حدوث خراج وقد ينصرف تلقائيًا أو يتم تصريفه جراحيًا من الجلد بجانب فتحة الشرج. ثم يشكل الناسور نفقًا تحت الجلد ويتصل بالغدة المصابة.

عادة ما تكون الجراحة مطلوبة لعلاج الناسور الشرجي.

الأعراض

Symptoms of an anal fistula can include:

  • An opening on the skin around the anus
  • A red, inflamed area around the tunnel opening
  • Oozing of pus, blood or stool from the tunnel opening
  • Pain in the rectum and anus, especially when sitting or passing stool
  • Fever

الأسباب

Most anal fistulas are caused by an infection that starts in an anal gland. The infection results in an abscess that drains on its own or is drained surgically through the skin next to the anus. A fistula is the tunnel that forms under the skin along this drainage tract. The tunnel connects the anal gland or anal canal to a hole in the outside skin around the anus.

Rings of sphincter muscle at the opening of the anus allow you to control the release of stool. Fistulas are classified by their involvement of these sphincter muscles. This classification helps the surgeon determine treatment options.

عوامل الخطورة

Risk factors for an anal fistula include:

  • Previously drained anal abscess
  • Crohn's disease or other inflammatory bowel disease
  • Trauma to the anal area
  • Infections of the anal area
  • Surgery or radiation for treatment of anal cancer

Anal fistulas occur most often in adults around the age of 40 but may occur in younger people, especially if there is a history of Crohn's disease. Anal fistulas occur more often in males than in females.

المضاعفات

Even with effective treatment of an anal fistula, recurrence of an abscess and an anal fistula is possible. Surgical treatment may result in the inability to hold in stool (fecal incontinence).

الناسور الشرجي - الرعاية في Mayo Clinic (مايو كلينك)

28/08/2020
  1. Abscess and fistula expanded information. American Society of Colon and Rectal Surgeons. https://www.fascrs.org/patients/disease-condition/abscess-and-fistula-expanded-information. Accessed March 17, 2017.
  2. Feldman M, et al. Diseases of the anorectum. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed March 17, 2017.
  3. Breen E, et al. Anorectal fistula: Clinical manifestations, diagnosis, and management principles. http://www.uptodate.com/home. Accessed March 17, 2017.
  4. Anorectal fistula (fistula in ano). Merck Manual Professional Version. http://www.merckmanuals.com/professional/gastrointestinal-disorders/anorectal-disorders/anorectal-fistula. Accessed March 17, 2017.
  5. Sneider EB, et al. Anal abscess and fistula. Gastroenterology Clinics of North America. 2013;42:773.
  6. Champagne BJ. Operative management of anorectal fistulas. http://www.uptodate.com/home. Accessed March 17, 2017.
  7. Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Jan. 25, 2017.
  8. Rajan E (expert opinion). Mayo Clinic, Rochester, Minn. March 24, 2017.

ذات صلة

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