What is an abscess. Causes of the appearance, symptoms and methods of treatment of an abscess. Abscess and its symptoms

Abscess - This is an acute inflammatory process caused by a bacterial infection, as a result of which, in the tissues of muscles, bones, organs or between them, an inflammatory focus is formed, a cavity filled with pus.

Pus consists of white cells (leukocytes), as well as blood serum and elements of destroyed tissue.

The cause of the abscess there may be many factors such as: non-sterile honey. instruments for surgical interventions, mechanical trauma to the skin, previous illnesses and, as a consequence, their complications in the form of abscesses, for example, pneumonia and tuberculosis.

The causative agents of such a reactive process are various microorganisms and bacteria, streptococci, staphylococci, etc. An abscess can also occur against the background of chronic diseases, with reduced immunity, with diabetes mellitus.

Causes of an abscess - Symptoms

The formation of an abscess (if an abscess is on the surface), with a halo of redness of the skin around it, swelling, pain on palpation, a local increase in skin temperature, as well as a general increase in body temperature. Internal organ abscesses are also caused by pain and fever.

Causes of an abscess - Diagnosis

An experienced specialist will determine the abscess during a visual examination of the patient, but there are deep abscesses of the internal organs and cannot be determined by eye. To correctly diagnose such processes, doctors have in their arsenal the following diagnostic methods such as: biochemical and general blood tests (with the formula), X-ray or ultrasound examination (ultrasound), magnetic resonance imaging (MRI), CT (computed tomography), microbiological studies the pus itself or tissue samples.

Causes of an abscess - Treatment

First of all, it should be remembered that self-treatment of an abscess can lead to disastrous results and irreparable consequences. Most often, the treatment of this problem requires surgical intervention, by opening a cavity filled with pus, after which the wound is treated with antiseptic drugs and drained.

Sowing purulent contents for sensitivity allows the doctor to choose the right antibiotic for the subsequent treatment of such an inflammatory process. When abscesses are not supplied with blood, drug treatment is ineffective.

After opening the abscess, an empty cavity is formed, after the healing of which a solid node, adhesion, scar is formed. Such defects on the skin do not look aesthetically pleasing, especially if the abscess has arisen on the face, neck or any other open area of \u200b\u200bthe body.

Such problems in our time can be solved by many methods, for example, the use of various absorbable scars with drugs or the method of laser therapy, chemical peels, etc.

And in conclusion, it should be recalled that an abscess, like all existing diseases, can be prevented. To do this, it is worth strictly observing the rules of timely diagnosis, as well as the surgical treatment of wounds, abrasions, scratches, even at first glance, quite insignificant.

During the treatment of various diseases, strictly observe and follow the entire range of procedures and appointments recommended by your doctor. By not ignoring all the above recommendations, you will avoid such a dangerous disease as an abscess, as well as its consequences.

An abscess (abscess, abscess) is a purulent inflammation, accompanied by tissue melting and the formation of a cavity filled with pus. It can form in muscles, subcutaneous tissue, bones, internal organs, or in the surrounding tissue.

Abscess formation

Abscess Causes and Risk Factors

The cause of the abscess is pyogenic microflora, which enters the patient's body through damage to the mucous membranes or skin, or is brought in with the blood stream from another primary focus of inflammation (hematogenous pathway).

The causative agent in most cases is a mixed microbial flora, in which staphylococci and streptococci predominate in combination with various types of bacilli, for example, E. coli. In recent years, the role of anaerobes (clostridia and bacteroids), as well as the association of anaerobic and aerobic microorganisms in the development of abscesses, has significantly increased.

Sometimes there are situations when the pus obtained during the opening of the abscess when sown on traditional nutrient media does not give microflora growth. This indicates that in these cases, the disease is caused by uncharacteristic pathogens, which cannot be detected by conventional diagnostic methods. To a certain extent, this explains the cases of abscesses with an atypical course.

Abscesses can occur as an independent disease, but more often they are a complication of any other pathology. For example, pneumonia can be complicated by a lung abscess, and purulent tonsillitis can be complicated by a paratonsillar abscess.

With the development of purulent inflammation, the body's defense system tends to localize it, which leads to the formation of a limiting capsule.

Forms of the disease

Depending on the location:

• subphrenic abscess;
• paratonsillar;
• periopharyngeal;
• soft tissues;
• lung;
• brain;
• prostate gland;
• periodontal;
• intestines;
• pancreas;
• scrotum;
• douglas space;
• appendicular;
• liver and subhepatic; and etc.

Subcutaneous tissue abscesses usually result in complete recovery.

According to the peculiarities of the clinical course, the following forms of abscess are distinguished:

1. Hot or spicy. It is accompanied by a pronounced local inflammatory reaction, as well as a violation of the general condition.
2. Cold. It differs from a normal abscess in the absence of general and local signs of the inflammatory process (fever, skin redness, pain). This form of the disease is typical for certain stages of actinomycosis and osteoarticular tuberculosis.
3. Indented. The formation of a site of accumulation of pus does not lead to the development of an acute inflammatory reaction. The formation of an abscess occurs over a long time (up to several months). Develops against the background of osteoarticular tuberculosis.

Symptoms of an abscess

The clinical picture of the disease is determined by many factors and, first of all, by the place of localization of the purulent process, the cause of the abscess, its size, and the stage of formation.

Symptoms of an abscess localized in superficial soft tissues are:

• swelling;
• redness;
• sharp soreness;
• an increase in local, and in some cases, general temperature;
• dysfunction;
• fluctuation.

Abdominal abscesses are manifested by the following symptoms:

• intermittent (intermittent) fever with a hectic type of temperature curve, i.e. subject to significant fluctuations during the day;
• severe chills;
• headache, muscle-joint pain;
• lack of appetite;
• severe weakness;
• nausea and vomiting;
• delay in passing gas and stool;
• tension of the muscles of the abdominal wall.

When the abscess is localized in the subphrenic region, patients may be disturbed by shortness of breath, cough, pain in the upper abdomen, which intensifies at the moment of inhalation and radiates to the scapula and shoulder.

With pelvic abscesses, reflex irritation of the rectum and bladder occurs, which is accompanied by the appearance of tenesmus (false urge to defecate), diarrhea, and frequent urination.

Retroperitoneal abscesses are accompanied by pain in the lower back, the intensity of which increases with the flexion of the legs in the hip joints.

Symptoms of a brain abscess are similar to those of any other masses (cysts, tumors,) and can vary in a very wide range, ranging from a minor headache to severe cerebral symptoms.

A lung abscess is characterized by a significant increase in body temperature, accompanied by severe chills. Patients complain of pain in the chest area, aggravated by trying to take a deep breath, shortness of breath and dry cough. After opening the abscess in the bronchus, a strong cough occurs with profuse sputum discharge, after which the patient's condition begins to improve rapidly.

Abscesses in the oropharynx (retropharyngeal, paratonsillar, periopharyngeal) in most cases develop as a complication of purulent tonsillitis. They are characterized by the following symptoms:

• severe pain radiating to the teeth or ear;
• sensation of a foreign body in the throat;
• muscle spasm that prevents opening of the mouth;
• soreness and swelling of regional lymph nodes;
• increased body temperature;
• weakness;
• nasal voice;
• the appearance of an unpleasant putrid odor from the mouth.

Diagnosis of an abscess

Superficial soft tissue abscesses do not cause difficulties in diagnosis. With a deeper location, it may be necessary to perform ultrasound and / or diagnostic puncture. The material obtained during the puncture is sent for bacteriological examination, which makes it possible to identify the causative agent of the disease and determine its sensitivity to antibiotics.

Oropharyngeal abscesses are detected during an otolaryngological examination.

Abscesses can occur as an independent disease, but more often they are a complication of any other pathology. For example, pneumonia can be complicated by a lung abscess, and purulent tonsillitis can be complicated by a paratonsillar abscess.

It is much more difficult to diagnose abscesses of the brain, abdominal cavity, lungs. In this case, an instrumental examination is carried out, which may include:

• Ultrasound of the abdominal and pelvic organs;
• magnetic resonance imaging or computed tomography;

Abscess treatment

At the initial stage of the development of an abscess of superficial soft tissues, anti-inflammatory therapy is prescribed. After the abscess has matured, it is opened, usually on an outpatient basis. Hospitalization is indicated only when the patient's general condition is severe, and the infectious process is anaerobic.

It is recommended to use Ilon ointment as an adjuvant in the treatment, as well as for the prevention of complications of abscesses of subcutaneous fat. The ointment should be applied to the affected area under a sterile gauze bandage or patch. Depending on the degree of suppuration, the dressing should be changed once or twice a day. The duration of treatment depends on the severity of the inflammatory process, but, on average, to obtain a satisfactory result, you need to apply the ointment for at least five days. Ilon K ointment is sold in pharmacies.

Treatment of a lung abscess begins with broad-spectrum antibiotics. After receiving the antibioticogram, the antibiotic therapy is corrected taking into account the sensitivity of the pathogen. If there are indications, bronchoalveolar lavage is performed to improve the outflow of purulent contents. The ineffectiveness of conservative treatment of an abscess is an indication for surgical intervention - resection (removal) of the affected area of \u200b\u200bthe lung.

Treatment of brain abscesses in most cases is surgical, as they can lead to dislocation of the brain and cause death. A contraindication to the removal of abscesses is their localization in deep and vital structures (subcortical nuclei, brain stem, optic tubercle). In this case, they resort to puncture of the abscess cavity, removal of purulent contents by an aspiration method, followed by rinsing the cavity with an antiseptic solution. If multiple flushing is required, the catheter through which it is administered is left in the cavity for a while.

Prevention

Prevention of the development of abscesses is aimed at preventing the ingress of pathogenic pyogenic microflora into the patient's body and includes the following measures:

• careful observance of asepsis and antiseptics during medical interventions accompanied by damage to the skin;
• timely conduct of primary surgical treatment of wounds;
• active rehabilitation of foci of chronic infection;
• increasing the body's defenses.

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Abscess - This is a purulent inflammation of tissues with the formation of a cavity, which is surrounded by a pyogenic membrane. Places of possible occurrence: bones , muscle , subcutaneous tissue as well as other organs.

The cause of an abscess can be various diseases ( retropharyngeal abscess with, tissue inflammation with pneumonia, trauma etc.), there are also known cases of independent occurrence.

The cause of an abscess is microbes, most often infection occurs through damaged mucous membranes, skin areas, as well as pathogens from another focus through the lymphatic and blood vessels. Thus, the abscess, through the formation of a capsule, exhibits the protective functions of the body, limiting uninfected tissue areas from infected ones.

There are several types of abscesses:

Cold abscess often seen in certain phases of the course actinomycosis or osteoarticular ... It is characterized by an accumulation of pus without general and local manifestations of the inflammatory reaction, which are characteristic of an ordinary abscess (increased body temperature, skin redness, pain).

Fluid abscess Is an abscess that is not accompanied by an acute inflammatory reaction, usually found in osteoarticular tuberculosis.

Subphrenic abscess A collection of pus, usually with gas, under the diaphragm (abdominal septum) is a complication of acute inflammatory diseases ( perforated ulcer of the duodenum or stomach, ).

The doctors

Abscess treatment

Early diagnosis followed by treatment is a prerequisite for successfully getting rid of purulent inflammation. The diagnosis of an abscess is a reason for surgery, therefore, in most cases, surgical methods are used to treat them. First, the purulent cavity is opened, then it is emptied and drained. Disposal of small abscesses of subcutaneous fat is performed on an outpatient basis and is a simple operation under local anesthesia.

In case of suspicion of an abscess of any internal organ, the patient is usually hospitalized in the operating room. With abscesses of some organs, puncture and aspiration of pus is performed, as well as the introduction of antibiotics.

After opening, abscesses are treated in the same way as purulent wounds. When prescribing antibiotics, the sensitivity of microflora to them is taken into account. In the case when purulent inflammation occurs against the background diabetes mellitus , normalization of metabolism is necessary. Treatment of abscesses in most cases occurs successfully, without the need for further surgical intervention.

List of sources

• V.K. Gostishchev Operative purulent surgery / A guide for doctors. - M., 1996;
• Blatun, L.A. Phlegmons and abscesses: modern treatment options / L.A. Blatun // Attending physician. - 2002. - No. 1-2;
• Svetukhin A.M., Amiraslanov Yu.A. Purulent surgery: current state of the problem // 50 lectures on surgery. - Ed. Academician V.S.Saveliev. - M .: Media Medica, 2003.

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A cavity filled with pus and delimited from the surrounding tissues and organs by a membrane.

A doctor of any profile in his practice can meet such an education as an abscess. Therefore, any specialist should have knowledge of the causes of its occurrence, symptoms and complications. A person who does not have a medical education also needs to familiarize himself with this information in order to consult a doctor in time if an abscess is suspected. It should be remembered that the treatment of an abscess is carried out strictly within the walls of a medical institution. The use of alternative medicine methods can lead to serious complications when a person's life is at risk.

What is an abscess?

An abscess is the presence of a focus of purulent fusion, delimited from healthy tissues by a connective tissue capsule. This pathological process can develop in any soft tissues, but the most frequent localization is the skin and soft tissues of the face, neck and buttocks. The presence of a capsule around the abscess is a kind of protective reaction of the body, aimed at delimiting the focus of purulent inflammation from healthy tissues and organs. contains microorganisms that caused inflammation, dead tissue cells (tissue detritus), dead microbial bodies, proteins and enzymes produced by the body and the pathogen, as well as blood cells (leukocytes, macrophages, mononuclear cells).

General and local symptoms of the disease

Regardless of where the abscess is located, the symptoms of the disease in each case tend to be of the same type. Clinically, a purulent abscess is manifested by local and general symptoms.

General somatic signs are not specific and are the result of general intoxication of the body. These symptoms include the following:

• Increased body temperature;
• Chills;
• Fatigue or fatigue;
• Headaches and muscle pain;
• Deterioration of health at night.

Local symptoms of an abscess are manifested by the following signs:

• Swelling and redness of the skin over the formation (if the abscess is under the skin);
• Sharp soreness of the skin over the affected area, aggravated by touch;
• A symptom of fluctuation - when palpating, you can feel the movement of fluid (pus) in the formation.

With the formation of a purulent abscess in the internal organs, general somatic symptoms come to the fore, and local symptoms are practically not detected.

In practice, surgeons and dentists often have to deal with such purulent-inflammatory processes as abscess and phlegmon. Difficulties arise at the stage of differential diagnosis, when it is necessary to distinguish one process from another in order to determine the tactics of treatment.

An abscess and phlegmon are united by the fact that they are both purulent-inflammatory diseases of soft tissues, often occurring as complications of infectious and inflammatory diseases of internal organs, the dentoalveolar system, and long-standing chronic foci of inflammation.

Unlike phlegmon, an abscess has a capsule that separates the site of inflammation from nearby healthy tissues. Phlegmon is a diffuse purulent inflammation of soft tissues that has no clear boundaries. But in the early stages of the development of an abscess, when the capsule has not yet been formed, but only the infiltration shaft is outlined, the abscess and phlegmon are practically indistinguishable. In such cases, the doctor takes into account the area covered by the inflammation. The more centimeters of tissue are involved in the inflammatory process, the more likely it is phlegmon.

But an already formed abscess can turn into phlegmon. This happens when the formation is large, when there is a lot of purulent contents inside, the walls of the capsule stretch and, unable to withstand the pressure of the liquid, break. The inflammatory exudate is poured into the surrounding soft tissue, causing an inflammatory response.

Acute and chronic abscess: disease symptoms

A purulent abscess is divided into acute and chronic. In an acute abscess, the abscess capsule consists of one layer. At the initial stage of development, it is only an inflammatory shaft of white blood cells migrating to the focus of purulent inflammation, then a young connective tissue rich in vessels (granulation) is formed. Over time, when the abscess takes a protracted course, the second (outer) layer of the capsule begins to form, which is a mature connective tissue. Thus, in an acute abscess, the capsule consists of one layer - young connective tissue, and in a chronic abscess, the capsule is two-layer - granulation tissue from the inside, and mature connective tissue from the outside.

The severity of symptoms depends on many reasons:

• Localization of the abscess;
• Its size;
• The causative agent that caused purulent inflammation;
• The reactivity of the body.

General somatic disorders are more pronounced in the acute course of the disease and are reduced to general toxic manifestations characteristic of any purulent infection: fever, weakness, body aches, headache, etc.

Local symptoms of an abscess depend on the location of the abscess. The closer it is to the skin, the more severe the symptoms are. In chronic course, both general and local symptoms are less pronounced.

An abscess can develop in almost any organ or tissue. The pathogenetic link in this process is purulent inflammation, which can occur in initially damaged tissues, for example, during trauma, or in tissues that are subject to severe microbial inflammation.

Allocate infectious abscesses and aseptic.

With an infectious abscess, various microorganisms act as an etiological factor. The most common "culprit" is staphylococcus, less often Escherichia coli and Pseudomonas aeruginosa, streptococcus, Koch's bacillus, as well as bacterial associations.

An aseptic abscess (without microbial inflammation) can develop in cases of the introduction of certain chemical or medicinal substances into the soft tissues of the body, for example, kerosene, cordiamine, etc. This can be found with the deliberate introduction of chemicals into soft tissues in order to create temporary disability. This forms an abscess after the injection (post-injection abscess).

Internal organ abscesses

Most often, doctors have to deal with abscesses of the lung, liver, and brain. The bulk of these formations are of an infectious nature, and are of a secondary nature, but there are other types of abscesses.

Lung abscess

Lung abscess in our country is a medical and social problem. The disease develops more often in special groups of the population, including people suffering from alcoholism, drug addiction, HIV, as well as living in unfavorable conditions. More often middle-aged men are ill.

In addition to the above factors, the causes of the development of a lung abscess can be diseases of the nervous system, diabetes mellitus, bronchiectasis, as well as conditions accompanied by impaired consciousness (coma, epilepsy, traumatic brain injury).

The ingress of an infectious agent into the respiratory system does not in itself cause disease, because the special mechanisms of the body ensure the sterility of the respiratory system. These include the epiglottis and cough reflexes, the mucociliary clearance system, and immune defenses.

All states accompanied by impaired consciousness, including alcohol intoxication and drug use, lead to a violation of the mechanism of natural "cleaning" of the bronchopulmonary system. In such persons, the epiglottis and cough reflex is reduced, and the immune system is weakened. Being in alcoholic or any other intoxication, vomiting often occurs, with reduced protective reflexes, particles of gastric contents easily enter the bronchi and lungs. In some cases, with massive aspiration of vomit, death from closure of the airways occurs, and in milder cases, inflammation of the lung tissue. Later, in the absence of adequate therapy, a lung abscess is formed.

The disease manifests itself with symptoms of intoxication of the body: high fever, chills, increased fatigue. Local symptoms are expressed in the form of chest pains on the affected side, dry cough, shortness of breath. These symptoms can get worse after exercise.

Over time, an abscess of the lung can spontaneously open with the outpouring of pus into the bronchus or pleural cavity. At the time of rupture, the pain symptom intensifies, if the abscess breaks out into the bronchus, then the fetid contents discharge through the mouth. After emptying, the patient becomes much easier.

When an abscess breaks into the pleural cavity, the general condition worsens. Shortness of breath, pain symptom increases, body temperature reaches high values. Empyema of the pleura (purulent inflammation of the sheets covering the lungs) develops.

A liver abscess can develop both in an unchanged organ and against the background of preexisting liver diseases or traumatic damage to the liver. By the nature of the occurrence, it is customary to distinguish the following types of liver abscesses:

• Hematogenous

The infection gets into the liver with the blood flow from other organs. More often this happens with sepsis, when the infection spreads from one organ to another. As a rule, small, multiple abscesses are formed. The prognosis for multiple purulent seeding of the liver is unfavorable.

• Cholangiogenic

The spread of infection from the area of \u200b\u200bthe bile ducts and gallbladder, which occurs with chronic cholecystitis, empyema of the gallbladder, purulent cholangitis, etc.

• Contact

The infection gets from nearby organs, in which a purulent-inflammatory process takes place. Most often it is the appendix and the large intestine (purulent appendicitis, diverticulitis, NUC).

• Post-traumatic

Suppuration in the liver occurs in damaged tissues that have died as a result of traumatic exposure. It is observed with blunt abdominal trauma (fight, accident), knife wound, as well as damage to liver tissue as a result of surgery.

Liver abscess is manifested by general intoxication symptoms, the following can be identified from characteristic complaints:

• Pain and heaviness in the right hypochondrium;
• Weight loss;
• Yellowness of the skin;
• Abdominal enlargement due to the accumulation of free fluid in the abdominal cavity (ascites).

Brain abscess

Brain abscesses are rare. A purulent formation in the brain always has a secondary nature, developing as a complication of the underlying disease. For reasons of development, brain abscesses are divided into the following types:

• Otogenic

Pus spreads to the brain tissue from the ear area in diseases such as otitis media, mastoiditis, eustachitis.

• Rhinogenic

Due to the spread of infection from the nasal area - with purulent forms of rhinitis, sinusitis.

• Metastatic

A purulent infection enters the brain region from distant organs, most often from the lungs in severe forms of purulent pneumonia.

• Post-traumatic

The brain tissue damaged during traumatic brain injury undergoes suppuration and encapsulation.

Brain abscesses are manifested by headache, fever. Depending on the localization of education, neurological symptoms appear: impaired speech, attention, memory, sleep disturbances, loss of vision, impaired coordination of movements, etc.

Treating a brain abscess is a serious problem. Firstly, difficulties arise even at the stage of diagnosis, since a brain abscess can proceed for a long time without pronounced symptoms and not be detected during a magnetic resonance imaging (MRI) examination until an abscess capsule is formed. Secondly, surgery on the brain is always a risk, especially if the abscess is large and located deep in the brain structures.

Appendicular abscess

An appendicular abscess develops as a complication of an acute, or rather its special form - appendicular infiltrate. The appendicular infiltrate is the involvement of not only the appendix in the inflammatory process, but also the adjacent loops of the small and large intestines, the peritoneum. A similar process is aimed at delimiting inflammation.

The infiltration develops 3-4 days after the attacks of acute appendicitis and is characterized by a subsiding of the pain symptom in the right side, a decrease in temperature, and an improvement in the patient's general condition. At the same time, a dense formation is felt in the right iliac region, appendectomy in the presence of an infiltrate is contraindicated, conservative treatment is used. But it was not without reason that the famous Soviet surgeon A.G. Brzhovsky: "Infiltrate is a wolf in sheep's clothing." Often, the infiltrate turns into an appendicular abscess, which is dangerous to health. A breakthrough of an appendicular abscess into the abdominal cavity ends with peritonitis (inflammation of the peritoneum), which can be fatal.

Appendicular abscess, symptoms:

• The temperature rises to high numbers.
• Pain typical for appendicitis in the right iliac region, aggravated by walking, physical exertion, change in body position.
• On palpation of the right iliac region, a painful infiltration is palpated, sometimes a symptom of fluctuation can be determined.
• Stool disorder (diarrhea, flatulence).
• With the localization of the abscess in the pelvic region - pain during bowel movements, frequent urination.
• When an abscess breaks into the intestinal cavity, there is a large amount of pus with a sharp unpleasant odor in the feces.

Otolaryngologists are people who have to deal with abscesses quite often. Such a frequency of the formations of this pathology is due to the high number of chronic inflammatory diseases of the ear, throat and nose. Throat abscesses develop as complications of diseases of the ENT organs, the leader among which is chronic tonsillitis. Most of them are infectious, less often the result of a throat injury.

Paratonsillar abscess

Paratonsillar abscess is a serious complication of chronic or acute tonsillitis. This is a purulent inflammation that forms in the peri-vascular tissue. It is caused by the same microorganisms that provoked inflammation of the tonsils. Predisposing factors are smoking, hypothermia, weakened immunity, traumatic effects on the tonsils (the habit of removing pus from the tonsils with improvised materials).

Patients with paratonsillar abscess indicate recent angina or a history of chronic tonsillitis. With this complication, the patient's well-being worsens, a sore throat intensifies, which does not make it possible to consume food and liquid, sometimes the patient cannot even open his mouth. The body temperature rises to high numbers, symptoms of intoxication are increasing: weakness, muscle pain, chills, headaches. The submandibular and cervical lymph nodes are enlarged, painful on palpation.

Paratonsillar abscess is dangerous with complications. In the absence of therapy, the development of purulent mediastinitis, sepsis is possible. Treatment of paratonsillar abscess is surgical in combination with antibiotic therapy.

Parapharyngeal abscess

The formation of a focus of purulent inflammation in the lateral wall of the pharynx is a parapharyngeal abscess. The process is usually one-sided. The disease develops as a complication of chronic tonsillitis, purulent processes in the sinuses, can be odontogenic in nature or be the result of a pharyngeal injury.

Parapharyngeal abscess is characterized by sharp pain on the side of the lesion, due to edema, the head is tilted in the direction where inflammation develops. Painful sensations intensify when swallowing, the patient has difficulty opening his mouth. When feeling the neck on the side of the lesion, there is pain, enlarged lymph nodes.

The process can be complicated by the spread of purulent inflammation in the mediastinal region, as well as phlebitis and trmbophlebitis of the jugular veins.

Retropharyngeal abscess

The formation of a focus of inflammation caused by a pyogenic flora in the pharyngeal tissue is called a pharyngeal abscess. The disease occurs more often in children under the age of 2 years, which is due to the anatomical and physiological characteristics of the child's body: looser fiber at this age and the presence of lymph nodes in this area, which undergo atrophy by the age of six.

In children, a pharyngeal abscess is most often the result of an infection from neighboring organs, which can occur with rhinitis, tonsillitis, ARVI, as well as after childhood infections such as scarlet fever, diphtheria, measles.

A retropharyngeal abscess in the adult population is usually a complication of trauma to the pharynx. Damage to this area can occur when sharp objects hit during a meal, for example, fish bones, as well as during medical procedures: FGDS, bronchoscopy, etc.

The disease proceeds with high fever and severe sore throat. The pain syndrome is so pronounced that it is difficult to swallow, therefore one of the characteristic symptoms observed in both children and adults is the inability to eat. Increasing swelling of the pharynx leads to a change in voice and difficulty breathing. In severe cases, asphyxiation may occur. In a dream, you can hear a "bubbling" in the throat, caused by the drainage of pus into the trachea.

The retropharyngeal abscess can be complicated by the development of purulent pneumonia, purulent meningitis, metastatic brain abscesses.

Gynecologists are also often involved in the treatment of abscesses. The development of abscesses in the pelvic area is facilitated by the anatomical and physiological characteristics of the female body. As well as frequent inflammatory diseases of the female reproductive organs, which, for one reason or another, a woman is in no hurry to treat. For example, a long-standing cyst of the glands of the vestibule of the vagina can become inflamed and turn into an abscess of the Bartholin glands. Also, a purulent abscess in the pelvic area and female genital organs can develop as a complication after surgery.

Douglas space abscess

The formation of a purulent focus with a capsule in the utero-rectal space (between the uterus and rectum) is called an abscess of the Douglas space. This type of abscess can develop not only in women, but also in men, then its localization will be the space between the rectum and the bladder.

The reason for the development of a purulent abscess in such a hard-to-reach place in women is purulent-inflammatory diseases of the female genital area - pyosalpings, inflammation of the appendages. Equally often in women and men, an abscess in the Douglas space develops after surgical interventions on the abdominal organs, as well as in complicated forms of appendicitis, when the appendix is \u200b\u200blocated in the pelvic region. This is due to the fact that the mesenteric sinuses open into the Douglas space. Poor sanitation (cleansing) of the operating field leads to the fact that blood, inflammatory exudate flows into this depression, and inflammation develops, leading to the development of an abscess.

In addition to the general symptoms of intoxication, the patient is worried about pain in the pelvic region, urge to urinate and defecate, increased pain during bowel movement. Sometimes fecal incontinence develops, and blood and mucus are found in the stool.

Treatment involves opening the abscess - in women through the vagina, in men through the rectum. Further, the abscess is drained by bringing a special drainage to it, the focus is sanitized. With a purulent abscess, not complicated by a breakthrough into the abdominal cavity, the prognosis is favorable - recovery occurs.

Tubo-ovarian abscess

A tubo-ovarian abscess is a purulent fusion of the tissue of the ovary and fallopian tube, merged into one conglomerate and having a capsule. The disease develops against the background of long-term inflammatory diseases of the uterine appendages (ovaries and tubes).

A tubo-ovarian abscess manifests itself with abrupt pain in the lower abdomen. Usually, an uncomplicated inflammatory process in the appendages is characterized by chronic dull pain in the abdomen, which intensifies on critical days and during intercourse. With the formation of an abscess, the pain becomes severe, unbearable, accompanied by a sharp increase in temperature, nausea, vomiting, purulent discharge from the vagina. Removal of the abscess is carried out surgically, it can be laparoscopic or abdominal surgery.

Bartholin gland abscess

Bartholin's glands are located in the vestibule of the vagina and produce a thick secretion (lubricant) that provides a woman with a comfortable sensation during intercourse. A Bartholin gland abscess often develops against the background of a long-standing cyst. Primarily, an abscess of the Bartholin gland occurs as a result of melting of the gland tissue by pyogenic microbes, a prominent representative of which is the gonococcus. Such an abscess is called true.

It is not difficult to diagnose an abscess of the Bartholin gland; an experienced specialist will do this even at the examination stage.

Abscesses in the oral cavity should be treated in dental surgery. Dentists often have to deal with this disease. In most cases, abscesses in this area of \u200b\u200bthe body arise due to problems with the teeth, or rather, as a result of timely untreated diseases of the teeth and gums - caries, periodontitis, pulpitis, granuloma, etc.

The most common are:

• Tooth abscess;
• Periomandibular abscess;

Tooth abscess

Tooth abscess is a purulent inflammation that forms on the lower or upper jaw, in the area from which the teeth grow. On the upper jaw - these are the alveolar processes, on the lower jaw - the alveolar part.

The formation of a tooth abscess is promoted by diseases of the gums and teeth, occurring chronically - neglected caries, periodontitis, gingivitis, cysts, granulomas. Also, an abscess can occur when the dentist is working with non-sterile instruments or as a result of incomplete cleaning of the tooth canals. An abscess can also occur as a result of trauma when a vertical tooth fracture occurs.

The disease manifests itself with acute toothache, which is aggravated by chewing and palpation of the tooth. Often there is edema, which can spread not only to the gums, but also to the cheek. Body temperature may rise and cervical lymph nodes may swell. An unpleasant odor emanates from the patient's mouth, there is a bitter taste in the mouth.

A tooth abscess is treated with drainage, when pus outflows through the hole in the tooth, the doctor rinses the cavity, and recovery occurs.

Periomandibular abscess

Periomandibular abscess is a purulent inflammation in the maxillofacial region with a capsule. It occurs as a result of a dislocation or fracture of the jaw, with a drift of infection during dental treatment, as well as in the chronic course of infectious diseases such as tonsillitis, facial furunculosis.

The disease begins with a toothache at the site of the development of the infectious process, the pain intensifies when chewing. After edema appears on the side of the lesion, a dense rounded formation is felt, the symmetry of the face is broken. The disease proceeds with an increase in body temperature, weakness, and decreased performance. A peri-maxillary abscess can open up on its own. After the expiration of pus, the state of health improves, but this does not mean complete recovery. The disease can become chronic and periodically exacerbate.

A delimited purulent inflammation in the thickness of the tongue is called an abscess. This is a fairly common pathology, both among adults and children. Most often it occurs as a result of traumatic damage to the mucous membrane of the tongue (fish bone, prostheses). The disease develops sharply and is manifested by an increase in the volume of the tongue, pain and difficulty in breathing. General health is disturbed, general intoxication symptoms join. An abscess of the tongue is a dangerous pathology, since when the abscess is localized in the region of the root of the tongue, asphyxia from the closure of the airways develops rather quickly, which leads to death.

Purulent abscess of soft tissues

A soft tissue abscess is a purulent inflammation located in muscle or adipose tissue, delimited by a pyogenic membrane (capsule).

The most common cause of purulent abscesses of soft tissues is staphylococcus, which penetrates through skin lesions resulting from injuries, burns, frostbites, etc.

Let's consider the most common localizations:

• Abscesses of the face and neck;

Abscesses of the skin of the face and body

Abscesses in the face and neck area are often diagnosed. They arise as a result of damage to the skin of this area with further penetration of infection and suppuration, or as a complication of other diseases, most often of an odontogenic nature (from the area of \u200b\u200bthe teeth).

Abscesses of the face and neck occur with a particularly vivid clinical picture, due to the complex anatomy of these parts of the body - the presence of a large number of blood and lymphatic vessels, lymph nodes and abundant innervation. Therefore, ulcers in the face and neck are characterized by severe pain syndrome, swelling, dysfunction of chewing, opening the mouth, the presence of facial asymmetry, inflammation of the regional lymph nodes.

Abscesses on the face can develop in the cheeks, parotid and infraorbital regions, in the chin and peri-maxillary region, etc. Dangerous by the development of facial vein thrombosis, meningitis, encephalitis, sepsis.

The anatomical features of this area contribute to the development of an abscess of the buttocks, namely: the presence of a well-defined fat layer, which is a favorable place for the vital activity of pyogenic microorganisms.

Purulent inflammation in the soft tissues of the buttocks occurs as a result of traumatic effects, after infectious diseases of the skin of this area, an abscess after an injection is a separate type.

Post-traumatic

Post-traumatic abscess develops a second time after soft tissue injury, followed by infection. It proceeds, like any other abscess, but it is preceded by wounds, abrasions or animal bites with a violation of the integrity of the skin of the buttocks.

Post-injection abscess (abscess after injection)

The most common abscess among the buttocks is a post-injection abscess, or post-injection abscess. It develops shortly after injection into the gluteus muscle and is characterized at first by compaction, pain, and then an abscess is formed, surrounded by a capsule. A fluctuation symptom, characteristic of abscesses, appears.

The reasons for the development of post-injection abscess:

• The introduction of a medicinal substance by mistake.

When injected into the muscle of the buttocks, drugs that must be administered in a different way - intravenously or subcutaneously. The drug does not dissolve, first forming an aseptic (without the presence of microbes) infiltrate, then the bacterial flora joins, an abscess of the buttocks is formed.

• Gross violation of the injection technique.

An abscess after an injection can develop if the rules for performing the injection are neglected. For example, using short needles for intramuscular injections or inserting only one third of the needle. Then the drugs do not reach the muscle tissue, and absorption slows down.

Performing large amounts at the same site can also cause post-injection abscess.

Penetration of a needle into a vessel with subsequent inflammation of the resulting hematoma.

Post-injection abscess can be formed on purpose, for example, after the injection of gasoline, turpentine, saliva into the muscle. This is done deliberately with the aim of creating an artificial disease, which allows evading the law or, for example, military service.

Post-injection abscess, symptoms:

• The appearance of pain at the injection site, aggravated by palpation;
• Redness and swelling, the skin in this place becomes hot;
• The formation of an infiltrate, and then a cavity filled with pus (a symptom of fluctuation);
• Breakthrough of the abscess outward or inward with the formation of a fistulous tract.

Abscess with infectious lesions of the gluteal region

An abscess in the gluteal region may be the result of a complicated infectious disease. Most often it is furunculosis, the favorite localization of which is the area of \u200b\u200bthe buttocks.

Abscesses of the buttocks can also develop with bedsores in this area in debilitated patients.

Abscess treatment is based on the ancient postulate of mechanical asepsis, which was used many centuries ago - "you see pus - release it." Therefore, the main method of treatment is surgical - opening the abscess, removing pus by drainage, washing.

Lancing an abscess

An abscess is opened regardless of where it is located. Cold abscesses that form as a result of leaks during the tuberculous process (nodules) cannot be opened.

Surgical removal of an abscess

An operation to remove an abscess of an organ is performed under general anesthesia, local anesthesia is used only in the case of superficial abscesses located in soft tissues close to the skin.

Removal of the abscess is not performed in the infiltration stage, when there is still no well-formed abscess capsule. At this stage, only conservative therapy is used. Surgical treatment of abscesses includes puncturing the abscess, then a small incision is made through the needle, the contents of the cavity are removed, after which the incision is expanded and the remaining pus and necrotic masses are thoroughly cleaned out.

After removal of the abscess, treatment is carried out according to the principle of purulent wounds.

Antibacterial therapy

The use of antibiotics for abscesses cannot guarantee complete recovery. Due to the large amount of pus and necrotic masses, the effectiveness of antibacterial drugs is greatly reduced. However, they can be prescribed in the postoperative period in complex therapy after a test for the sensitivity of microflora obtained with pus during abscess drainage.

Prevention of the development of abscesses is reduced to simple rules of asepsis and antisepsis, as well as careful attention to your health.

It is necessary to regularly undergo preventive examinations in order to timely diagnose diseases.

• Sanitize foci of chronic infections.
• Treat wounds, abrasions and other injuries in a timely manner.
• Trust only healthcare professionals to perform injections.

Content

The pathological condition can develop independently or be a consequence of other diseases. A characteristic feature of an abscess (abscess) is the presence of a pyogenic membrane or membrane in the focus of inflammation, which separates the affected area from healthy tissues. Find out what steps you need to take to avoid complications of this disease.

The causes of the abscess

The abscess capsule prevents the spread of germs and their toxins throughout the body. Answering what an abscess is, experts define this term as purulent inflammation, which is accompanied by the melting of tissues and the formation of a cavity filled with exudate, which limits the infectious focus. An abscess can occur in muscles, subcutaneous tissue, and internal organs. The purulent contents of the capsule are an accumulation of leukocytes, interstitial fluid, phagocytes. The causative agent is a mixed flora with a predominance of staphylococci, streptococci, Escherichia coli.

Recently, the role of anaerobes in the formation of abscesses has increased. Clostridia, bacteroids, associations of aerobic and anaerobic microorganisms are frequent inhabitants of abscesses. In a situation where the secreted pus during sowing on traditional nutrient media does not give microflora growth, a conclusion is made about the atypical course of the abscess. An abscess provoked by uncharacteristic pathogens, which cannot be detected by conventional diagnostic methods, is dangerous for the development of severe complications.

Abscess classification

According to the characteristics of the clinical course, a hot, cold and sinuous abscess is distinguished. The first form is accompanied by local inflammation, a violation of the general condition. A cold abscess develops almost asymptomatically. A leaky abscess is characterized by the formation of an area of \u200b\u200baccumulation of exudate without signs of an inflammatory process. The formation of such an abscess occurs over a long time. In addition, abscesses are classified by duration and location:

• By the duration of the course, a purulent lesion is:

• sharp;
• chronic.

• According to the localization of the purulent focus, there are:

• abscess of soft tissues;
• oral cavity;
• purulent abscess of Bezold;
• appendicular;
• subcutaneous abscess;
• lungs (lung);
• purulent inflammation of the brain;
• retropharyngeal;
• purulent liver damage;
• subphrenic;
• purulent spinal epidural abscess;
• paratonsillar;
• small pelvis;
• interintestinal.

Stages of an abscess

The pathological process is divided into two stages: development and breakthrough. In a situation where a purulent abscess is chronic, the second stage is absent. In this case, it is replaced by a stage of arbitrary changes in the tissue structure. The duration of the first stage varies. A breakthrough of an abscess, or an independent exit of exudate from the cavity, is accompanied by an improvement in the patient's condition. Physiologically, this stage lasts for several days. If the abscess does not break through on its own, the capsule is surgically opened.

Symptoms

The severity of the signs of the disease depends on the location, size and stage of formation of a purulent abscess. When an abscess is located in the subphrenic region, the patient experiences shortness of breath, cough, abdominal pain. Pelvic abscesses cause reflex irritation of the bladder and rectum, which provokes tenesmus, increased urination. An abscess in the retroperitoneal cavity is accompanied by pain in the lower back. Depending on the location, the following signs of an abscess are distinguished:

• Purulent inflammation of soft tissues causes:

• redness;
• swelling;
• soreness;
• temperature rise;
• fluctuation.

• In the abdominal cavity:

• fever;
• severe chills;
• tachycardia;
• lack of appetite;
• headache;
• weakness;
• nausea, vomiting.

• Symptoms of purulent brain damage vary in a wide range, from headache to severe cerebral symptoms.
• A purulent abscess of the lung provokes:

• fever;
• dry cough;
• chest pain;
• shortness of breath.

• In the oropharynx manifests itself:

• pain that radiates to the teeth or ear;
• muscle spasm;
• soreness, swelling of regional lymph nodes;
• an increase in temperature;
• insomnia;
• nasal voice;
• the appearance of a putrid odor from the mouth.

No one is immune from postoperative complications. The development of an abscess occurs due to the attachment of a secondary infection, high tissue reactivity in the suture material, and improper postoperative drainage. Antibiotic therapy in this case does not have the expected effect. A purulent abscess after surgery is characterized by the following symptoms:

• high temperature;
• swelling, redness of the seam area;
• pain with pressure.

Diagnostics

Identification of superficial abscesses is not difficult, while deeply located infiltrative capsules require ultrasound and / or puncture. The exudate obtained as a result of a puncture of the pyogenic membrane is sent for bacteriological examination, during which the causative agent of the disease and its sensitivity to antibiotics are determined.

The defeat of the oropharynx is detected during an otolaryngological examination. With any localization of the abscess in the blood test, signs of an acute inflammatory process are found in the form of an increase in the number of leukocytes, an increase in ESR, and a shift in the leukocyte formula to the left. Diagnostics of abscesses of the brain, lungs, abdominal cavity is carried out using:

• Ultrasound of the abdominal organs, small pelvis;
• magnetic resonance imaging, computed tomography;
• radiography.

Abscess treatment

Purulent inflammation of superficial soft tissues is eliminated by prescribing anti-inflammatory drugs to the patient. The ripe abscess is subsequently opened on an outpatient basis. Treatment of an abscess of soft tissues in a hospital is carried out in the case of a severe general condition of the patient or an anaerobic nature of the infectious process.

Therapy of an abscess localized in the lung tissue is carried out using broad-spectrum antibiotics, selected taking into account the sensitivity of the pathogen. In order to improve the outflow of exudate from the abscess, bronchoalveolar lavage is performed. The ineffectiveness of the conservative measures used is an indication for the prompt removal (resection) of the abscess.

Due to the fact that brain damage can lead to the development of dislocation syndrome and cause death, it is treated surgically. Inoperable ulcers in deep structures are punctured. In this case, the removal of exudate is carried out by an aspiration method, followed by washing the abscess cavity with an antiseptic solution. Puncture is a less traumatic and extremely effective way to eliminate abscesses. The infiltrative capsules in the abdomen are removed surgically.

Folk recipes

Superficial abscesses are allowed to be treated at home. In a situation where the process takes on a long-term nature, the abscess is opened surgically, without waiting for its independent breakthrough. In the case of localization in internal organs, self-medication is unacceptable due to the high risk of complications. Treatment of an abscess at home can be done with one of the following folk remedies:

• Bow. Grate the raw product. Wrap the resulting gruel in gauze and attach to the abscess. For the same purpose, you can use an onion cooked in milk. Change the lotion every 3-4 hours.
• Onion with soap. Rub the baked onion with baby soap. Place the composition on a cotton pad and apply to the abscess. Change the lotion every 5 hours.
• Honey ointment. Mix equal parts of honey, Vishnevsky ointment and alcohol until smooth. Apply the finished composition for superficial abscesses under the bandage and leave overnight.
• Potatoes. Grate the crude product on a coarse grater and apply the resulting mass to the abscess. Cover the abscess affected area. Change the dressing after 4 hours.
• Burdock. Chew the fresh root of an annual plant on an empty stomach. Apply the resulting mass to the abscess for a day.

Complications of an abscess

With adequate treatment, the outcome of the disease is favorable. Failure to seek medical attention or misdiagnosis can lead to serious consequences. The severity of complications and the risk of their development is determined by the localization of the abscess, the causative agent of the infection, and the state of the immune system. Brain damage always has a serious prognosis. A fatal outcome ends in about 10% of cases, while in 50% of patients there is a persistent disability. In addition, a purulent abscess can provoke:

• gangrene;
• infectious toxic shock;
• complete or partial loss of functionality of the affected organ;
• sepsis;
• phlegmon;
• neuritis;
• purulent meningitis;
• peritonitis;
• empyema of the pleura.

Prevention

In order to avoid the penetration of pyogenic microflora into the body, it is necessary to treat infectious diseases in a timely manner and prevent their transition to a chronic form. It is important to maintain the body's immune system. Special attention should be paid to staying in the fresh air, adherence to sleep and rest. Prevention of the development of purulent abscesses also includes the following measures:

• compliance with the rules of asepsis and antiseptics during medical procedures;
• active rehabilitation of foci of chronic infection;
• timely primary surgical treatment of wounds, bursting abscesses.

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