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直肠癌报告模板解读与肛瘘的MR诊断


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肛瘘一般指肛管直肠瘘,中国传统医学称为痔漏,是常见的肛门疾病。肛门瘘管是肛管或直肠与肛周皮肤相通的肉芽肿性管道,主要侵犯肛管,很少涉及直肠,故常称为肛瘘,内口多位于齿状线附近,外口位于肛周皮肤处。整个瘘管壁由增厚的纤维组织组成,内复一层肉芽组织,经久不愈。发病率仅次于痔,多见于男性青壮年,可能与男性的性激素靶器官之一皮脂腺分泌旺盛有关。肛瘘大多是非特异性感染,少数是结核性的。主要症状是肛周或臀部瘘口经久不愈,或时愈时溃,溢出脓液,刺激局部皮肤痒痛不适等。肛瘘不能自愈,不治疗会反复发作直肠肛管周围脓肿,因此必须手术治疗。



Anal fistula, or fistula-in-ano, is a chronic abnormal communication between the epithelialised surface of the anal canal and (usually) the perianal skin.

Anal fistulae originate from the anal glands, which are located between the internal and external anal sphincter and drain into the anal canal. If the outlet of these glands becomes blocked, an abscess can form which can eventually point to the skin surface. The tract formed by this process is the fistula.

Abscesses can recur if the fistula seals over, allowing the accumulation of pus. It then points to the surface again, and the process repeats.

Anal fistulas per se do not generally harm, but can be very painful, and can be irritating because of the pus-drain (it is also possible for formed stools to be passed through the fistula); additionally, recurrent abscesses may lead to significant short term morbidity from pain, and create a nidus for systemic spread of infection.

Surgery is considered essential in the decompression of acute abscesses; repair of the fistula itself is considered an elective procedure which many patients elect to undertake due to the discomfort and inconvenience associated with a draining tract.









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