Kriptit – an inflammation of bosoms (blind pockets) of back pass owing to infection of crypts. Clinical symptoms are characterized by emergence of weight, burning sensation, moistening of skin of an anus, pains and a lumbago of a rectum. Complicated kriptit quite often passes in proktit and paraproktit, leads to development of a lock, anal cracks, formation of fistulas, promotes development of cancer of rectum. Pathology is diagnosed by the proctologist by means of a manual research of back pass, an ultrasonografiya, an anoskopiya and a rekotoromanoskopiya. Treatment of a kriptit conservative (diet, normalization of a chair, respect for hygiene, sedentary bathtubs); at inefficiency - surgical.
Kriptit - it is an acute or chronic inflammation of a morganiyevy crypt (anatomic deepening in a terminal piece of a rectum). Morganiyevy crypts in the top part have the message with a rectum, and from below are covered with semi-lunar gates (valves). Mouths of channels of anal glands come to a surface of a bottom of morganiyevy crypts. As a result of insufficient drainage of a crypt, obstruction of the mouth of a channel, a mechanical trauma of a crypt can inflame.
Depth of crypts is individual. Deep crypts are more inclined to development of inflammatory process. Besides, stagnation of kalovy masses, a microbic infection can also serve as the cause of a kriptit.
Chronic locks and ponosa lead to mechanical damages of crypts by kalovy masses, promote stagnation of pathogenic microbic flora. Sharp kriptit it is inclined to turn easily in chronic thanks to lack of normal drainage of crypts, repeated infection, regular traumatizing. Long hard proceeding kriptit threatens with development of such complications as proktit and paraproktit, an anal crack, rectum cancer.
Reasons of a kriptit
Crypts are freely reported with a rectum gleam and therefore hit of kalovy masses in them is not a rare situation. As a rule, crypts are completely emptied, and the secret of anal glands does not allow an infection to get into deep layers.
When traumatizing a crypt firm components of kalovy masses (bran, bristles, a peel, pieces of stones, etc.), hit of sweaty lumps the calla in a crypt or hypostasis of its walls at long diarrhea, obstruction of a channel of anal gland develops inflammatory process. Stagnation of kalovy masses in a crypt and decrease in protective properties of a secret of anal glands promote reproduction of pathogenic microorganisms.
Thus, any disorder of defecation, the minimum traumatic injury of a mucous rectum can become the cause of a kriptit. Obstruction of anal glands promotes penetration of bacteria into deep layers and development of a paraproktit.
Symptoms of a kriptit
Kriptit it is shown by pain in back pass (proktalgiya), especially, during defecation. Pain can be various character and intensity, from weak stupid morbidity to a burning and sharp lumbago with irradiation. Burning, weight in a rectum, feeling of presence of a foreign matter is sometimes noted. Quite often patients note blood streaks in Calais. Release of pus from back pass usually is followed by an intensive perianalny itch. The hyperthermia is not characteristic.
When forming an abscess pain becomes pulsing, picking. As the pain syndrome often is associated with defecation, patients are inclined to detain depletion of intestines that causes aggravation of a state. Quite often the spasm of an anal sphincter develops.
In case of elimination of an etiologichesky factor and restoration of a drainage of a crypt usually there is a subsiding of clinical symptoms, and in case of an acute inflammation – and recovery. The long inflammation can pass to other crypts, extend on mucous a pryamokishechny wall, in overlying parts of a large intestine, and also in deep layers. Chronic kriptit proceeds wavy, the periods of remissions are replaced by the aggravations provoked by various frustration of a chair, travmatizatsiy wall of a gut, the general easing of protective properties of an organism.
Complications of a kriptit
In case suppuration in a crypt is not opened independently in a gut gleam, the inflammation can extend to surrounding fabrics (the next crypts, mucous a rectum, surrounding fatty cellulose). Proktita, paraproktita, rectum fistulas become result.
If there was an opening of abscess in a crypt, but drainage is not enough, or the factors which served as the reason of development of a kriptit are not eliminated (defecation difficulties continue, it is repeatedly injured mucous, the drainage of a crypt is insufficient), kriptit gets a chronic current.
Chronic kriptit is fraught with development of cicatricial deformations of a wall of a rectum, to formation of incomplete fistula, formation of rough cicatricial fabric in the area where the bottom of crypts is located (). If mentions more, than a quarter of the fabrics covering the anal channel, elastichesky properties of its walls, rectum tensile properties decrease. It promotes aggravation of difficulties of depletion of intestines.
Diagnostics of a kriptit
Besides poll, detection of complaints, collecting the anamnesis and fizikalny inspection (including survey and a palpation of a crotch and a perianalny zone), to measures of diagnostics of a kriptit treat a manual research of back pass with careful inspection of area of an arrangement of crypts for identification of a zone of local morbidity, puffiness, suppuration. Anoskopiya and a rektoromanoskopiya allow to examine carefully the anal channel, final department of a rectum, to investigate a condition of mucous, to visualize the inflamed crypt (hypostasis, hyperaemia mucous, a fibrinous raid, when pressing can be noted an otkhozhdeniye suppurating).
In certain cases (seldom) at an anoskopiya it is possible to find the mouth of an output channel of anal gland which is allocated with a bright scarlet point on hyperemic mucous. Rektoskopiya allows to estimate a condition of a mucous membrane of a direct and sigmovidny gut, to exclude possible pathologies. Capture of a biopsy of doubtful sites of an intestinal wall allows to exclude a malignant new growth. In need of specification of data it is possible to carry out an ultrasonografiya (by means of the rectal sensor) and a proktografiya. Formation of fistulas demands their research by means of a fistulografiya.
Sharp kriptit, and also the aggravation chronic needs to be differentiated from a paraproktit (generally intermuscular). Differences come to light at a manual research of back pass. At inspection of area of an arrangement of crypts infiltration of the fabrics located more deeply than a crypt is noted. Incomplete fistula of a rectum is usually shown by allocation of a drop of pus from an anus during cultivation of walls of the anal channel.
Treatment and forecast of a kriptit
Kriptit without complications is subject to conservative treatment at the proctologist. For decrease in irritant action of kalovy masses on mucous a rectum exclude hot, salty, sour dishes, alcohol from a diet of patients. For maintenance of a normal rhythm and character of defekation the volume low-fat food which is carefully cooked or steamed the sufficient volume of liquid, boiled vegetables (as prevention of locks), porridges is recommended. Laxatives at a lock are not recommended, it is more preferable to release intestines by means of enemas. Depletive can promote excessive fluidifying of a chair, increase of defekation, additional irritation and puffiness of a mucous membrane of a rectum.
Careful hygiene of anal area is recommended to patients with kriptity: after defecation a podmyvaniye warm water, daily 10-15 minute sedentary warm (37-38 degrees) trays with weak solution of potassium permanganate. For 7-10 days before going to bed register microenemas with kollargoly (30-40 ml of 3% - solution). In case of inefficiency of therapeutic methods or development of complications surgical treatment is shown.
Sharp kriptit most often it is allowed by opening of abscess in a crypt and a stukhaniye of signs of an inflammation with full treatment. In case of a recurrence of inflammatory process there is a synchronization. In that case timely, careful and adequate treatment as the chronic inflammation of a crypt leads to distribution of process on surrounding fabrics is necessary.