1 SUPPURATION ANALE FISTULE ET ABCES 2 SUPPURATION ANALE FISTULE ET ABCES
Cours 4ème année Médecine C
Abcès et fistule 1 seule maladie
suppuration dorigine anale propre
point de départ infection de glande dHermann et Desfosses (cryptes)
toujours rechercher ce point de départ.
4 I- ETIOPATHOGENIE
Germes en cause germes intestinaux
Toute fistule passe par 3 stades stade primaire orifice primaire stade dextension trajet stade terminal orifice secondaire
5 II- CLASSIFICATION 6 III- CLINIQUE
A- phase aiguë ou phase dabcès 1-clinique douleur progressivement croissante battantes non rythmée /selles insomnie syndrome infectieux souvent peu important 2-examen inspection masse rouge tendu / fesse marge anale TR orifice interne abcès intra-mural anuscopie rarement possible car Dl
7 B- PHASE CHRONIQUE OU PHASE DE FISTULE
1-Clinique écoulement purulent prurit
Examen orifice secondaire orifice primaire trajet
8 (No Transcript) 9 IV- DIAGNOSTIC DIFFERENTIEL/
Cancre à forme fistulisante
Lésions suppurées spécifiques ( tuberculose analemaladie de Crohn HIV)
Maladie de Verneuil
10 V- TRAITEMENT
EXCLUSIVEMENT PCOCTOLOGIQUE chirurgie
Abcès incision dabord (soulager)
Abcès fistule anale
Fistule traitement proctologique
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