Complications of appendicitis. Postoperative fistula treatment What are cancer fistulas

A fistula is a pathological passage connecting a hollow organ or any cavity with the outer integument (external fistula) or hollow internal organs (internal fistula).

Classification.

I By origin.

1 Congenital. They are formed as a consequence of developmental defects (median and lateral fistulas of the neck and umbilical fistulas). Always labiform.

2 Purchased.

a) caused by a pathological process as a result of inflammation (chronic osteomyelitis, tuberculosis of bones and joints, ligature fistulas, tumor decay, etc.)

b) created surgically (cystostomy, colostomy, nephrostomy)

II In relation to the external environment.

1 External.

2 Internal.

III Construction.

1 Granulating (tubular). The walls of these fistulas are covered with granulations. They can close on their own.

2 Labiform. The epithelium of the hollow organ is directly transferred to the skin. Self-closing is not possible.

IV According to the nature of the discharge.

Urinary. Salivary. Feces. Liquor. Purulent. Mucous.

When acquired fistulas are associated with a purulent-necrotic process in the thoracic organs, abdominal cavity, traumatic damage to hollow organs, parenchymal organs, surgical manipulations (deserosed areas of the intestine, microperforations, etc.). The most common pathology in abdominal surgery is external intestinal fistulas (2.4% of the number of emergency operations on the abdominal organs). Mortality 16-54%. With a high intestinal fistula or pancreatic fistula, large losses of electrolytes, water, and proteins occur, which leads to disruption of homeostasis and sudden weight loss in patients due to digestive disorders.

Treatment. General. Correction of homeostasis disorders. For high fistulas of the small intestine and fistulas of the pancreas, transfer of patients to total parenteral nutrition is indicated. Local. Treatment of the wound, protection of the tissues surrounding the fistula from the effects of digestive juices, sanitation of purulent fistulas. Skin protection can be done with ointments, pastes (Lassara paste, zinc ointment, medical glue, polymerizing film, silicone pastes, etc.). In order to reduce secretion and its activity, protease inhibitors, sandostatin, are used. When indicated, various pelota and obturators can be used. One of the main methods of treatment remains surgical, aimed at surgical elimination of the existing fistula.

Tumors

Oncology- the science that studies tumors.

The subject is blastomas or true tumors, as opposed to various swellings that arise due to edema, fluid filling, hemorrhages, etc.

A tumor is a focus of pathological growth, spontaneously arising in various organs, characterized by structural polymorphism and isolation.

Benign Malignant

1.Characterized by slow progression 1.Rapid growth

2. Expanding nature of growth 2. Infiltrating growth

3. Presence of capsule 3. Absence of capsule

4.Do not recur after radical surgery 4.Recur

5.Do not metastasize 5.Metastasize: lymphogenously,

6. In structure they differ little from the tissues from which hematogenously, implantation

occur: 6. Affect the general condition

Epithelial: adenoma of the body – cancer intoxication

Muscular: fibroids (anemia, fever

Connective tissue: body fibroma, wasting)

Cartilaginous: chondroma 7. By structure they can be:

Fatty: lipoma - highly differentiated,

Nervous: neuroma - differentiated,

Congenital: teratoma - poorly differentiated

Etiology: completely unknown. Has not lost its meaning:

1. Virchow’s theory of irritation - prolonged exposure to irritating substances.

2. Conheim's theory of embryonic origin of tumors.

3. Viral-immunological theory of Zilber: vir. – on – oncogene – normal (normal regulation of cell division).

4.Theory of cancer evasion. Mutation and transformation.

5. Fischer-Varels regeneration-mutation theory (during the process of regeneration, many young, actively reproducing cells appear).

6. Chemical theory, etc. and so on.

Currently, the polyetiological theory has achieved the greatest recognition: for carcinogenic substances; genetic factors; viruses.

90% of tumors arise under the influence of external oncogenic factors; 10% - genetic and viral.

Carcinogens: physical (radiation); chemical (polycyclic aromatic hydrocarbons - benzidine, benzopyrene, etc.).

Tumors are divided into:

1. Type of tissue in which the tumor develops

2. Localization

3. Morphological features and ability to spread

Precancerous diseases: trophic ulcers, fistulas, chronic gastric ulcers, anacid gastritis, gastrointestinal polyps, mastopathy, papillomas, birthmarks, cervical erosion, etc.

Clinical observation, biopsy.

Detecting a tumor at an early stage is very difficult, but is the key to successful treatment. From the patient's medical history, it is necessary to pay attention to the patient's living conditions and habits, place of residence (south - skin cancer; lung cancer– industrial area, smoking, etc.). IN initial stages complaints are often absent. It is necessary to pay attention to the slightest change in the patient’s well-being, the appearance of new, previously uncharacteristic complaints: fatigue for no apparent reason, aversion to food (especially meat), changes in the shape or color of an existing skin lesion, etc.

Minor Sign Syndrome: increased fatigue, drowsiness, decreased interest in the environment, indifference to what was previously fascinating, decreased performance, lack of satisfaction from physiological functions, a feeling of heaviness, the presence of a foreign body.

Oncological alertness:

1. knowledge of the symptoms of malignant tumors in the early stages

2. knowledge of precancerous diseases and their treatment

3. quick referral of the patient to an oncology clinic

thorough examination

5. in case of an atypical course of the disease, think about a possible oncological process

When examining patients with precancerous diseases, the following syndromes are distinguished:

1. Syndrome + tissue

2. Pathological discharge syndrome

3. Dysfunction syndrome

Pain is not typical for a tumor.

Shape, consistency, mobility.

Diagnostic methods:

1. General clinical

2. Additional

Endoscopic (FGDS, FCS, bronchoscopy, laparoscopy)

Cytological diagnostics (imprint smears, cytological examination punctate)

Morphological - biopsy

X-ray

Radionuclide diagnostics

Ultrasonography

CT scan

Laboratory

Classification:

Stage I – the tumor is localized, occupies a limited area, does not grow into the wall of the organ, and there are no metastases.

Stage II - a large tumor, grows into the submucosal - muscle layer, but does not go beyond it, single metastases in regional lymph nodes.

Stage III – a large tumor that grows throughout the entire wall, nearby organs, and multiple metastases in regional lymph nodes.

Stage IV – distant metastases.

TNMP T-tumor T 1-4

N-nodula N0–N3

M-metastasis M0-M1

P-histological criterion P1- mucous membrane

P2- + submucosa

P3- + subserrous layer

P4- + serous layer

General principles of treatment:

1. Surgical

2. Radial

3. Chemotherapy

4. Hormonal therapeutic

5. Combined methods

Combination of surgery + radiation (pre-, intro-, post-operative)

Irradiation+chemo. (lymphogranulomatosis)

Radiation – lip cancer

Hormonal – breast cancer

The principle of the field is removal in a single block within healthy tissues.

Antiblastics – electric, laser, ultrasound, intra-art. Administration of antitumor drugs.

Surgical

1. Radical operation– tumor + regional lymph nodes

2. Combined surgery - removal of an organ or part of it where the tumor grows

3. Palliative – metastatic tumors remain

4. Symptomatic – elimination of complications

Radiation

More than 50% of patients.

Independently – in patients with cancer of the lips, cervix, skin. Basically, it is combined with surgical treatment.

Highly sensitive: lymphosarcoma, myeloma, semenoma, chorionepithelioma.

Hormone therapy

Used in combination with other methods. Used in the treatment of breast and prostate cancer. Female and male sex hormones.

Chemotherapy

Used in combination with other treatment methods. Great importance has in leukemia, lymphogranulomatosis.

Cytostatics: novembiquin, cyclophosphamide, thiophosphanide, dopan, vinglastin, vincristine. They inhibit the proliferation of tumor cells, affecting their mitotic activity.

Antimetabolites: act on the metabolism in the cancer cell, inhibit purine synthesis or affect enzymatic systems.

Antitumor antibiotics are substances produced by fungi or microorganisms (actinomecin C and D, brullomycin - suppress DNA-dependent RNA synthesis).

Most often, chemotherapy drugs are used in multiple chemotherapy drug (OMF) regimens.

Organization oncology service

Built according to the type of dispensary service. Each region (region) has its own oncology clinic; in large cities (Moscow, St. Petersburg) there are city oncology clinics. There are dispensaries serving patients (mammology dispensary). In district clinics, the staff of oncologists is eliminated, or the function of the oncologist is combined by the clinic surgeon. There are research institutes of oncology (Moscow, Tomsk). The oncological service of the Russian Federation is headed by the Moscow Oncological Institute named after. Herzen, Oncology Research Center of the Russian Academy of Medical Sciences.

Main tasks in organizing an oncology service

1. Prevention of cancer incidence

2. Early diagnosis, including medical examinations

3. Treatment of cancer patients

4. Monitoring cancer patients after treatment

5. Symptomatic treatment (it turns out local service)

6. Carrying out specialization and upgrading of classification of doctors

7. Organizational and methodological work

8. Sanitary education work

(fistula) is a normally absent pathological passage in tissues, which is a narrow channel lined with epithelium or granulation tissue. A fistula connects an organ, natural or pathological cavity to the surface of the body or to each other. There are two types of fistulas:

external fistula - connects the internal cavity with the surface integument;
internal fistula - connects hollow organs.

The latter should be distinguished from an anastomosis performed artificially for therapeutic purposes. Fistulas are also divided into congenital, which arise as a result of a violation of embryonic genesis (developmental defects), and acquired, which can be caused by trauma, tumors, or inflammatory diseases. Fistulas are also the result of surgery, which ended with the artificial formation of an external fistula and is an intermediate or final stage of surgical treatment. For example, gastrostomy, colostomy, etc.

According to their structure, fistulas are divided into tubular, the walls of which are covered with granulation tissue, and labiform, the walls of which are lined with epithelium. Tubular or granulating fistulas are covered from the inside with granulation tissue along the entire length of the canal and tend to close on their own. Labial fistulas are covered with epithelium, which directly passes into the epidermis of the outer skin. Such fistulas do not tend to close on their own and require surgical excision and closure.

Fistulas are also distinguished by the nature of the discharge: mucous, purulent, urinary, bile, fecal, salivary, liquor. In the secretion of the fistula, pathological elements are often found that help in making a diagnosis - mycobacterium tuberculosis, malignant cells, etc. Discharge from the fistula, getting on the skin, can cause irritation, maceration and the formation of ulcers. In particular, this is observed in duodenal, small intestinal and pancreatic fistulas.

An external fistula has an external skin opening, a canal and an internal opening. Some fistulas do not have a canal, since the wall of the organ can reach the thickness of the skin or even protrude above it, forming a lip.

Labial fistulas can be complete, if the contents of the organ are released outside, and incomplete - in which the contents of the organ, for example the intestine, are only partially released through the lumen of the fistula. For such development, the spur, which is formed as a result of the loss of back wall intestines into the lumen of the fistula. The length of the fistula depends on the thickness of the tissues through which it runs, the mobility of the organ, its displacement by the pathological process, as well as the presence of adhesions between organs. The cutaneous opening of an external fistula can vary in size and shape. Most often, external fistulas are single, but they can also be multiple. The mechanism of formation of multiple fistulas looks approximately as follows: numerous flows of organ contents and pus occur into an already existing single fistula, which leads to the formation of multiple abscesses, which subsequently break out and form multiple fistulas. Actinomycosis is a disease in which primary multiple fistulas most often form.

Symptoms and diagnosis of fistulas

The clinic of fistulas consists of local and general symptoms. Local symptoms include: the presence of a fistula, its localization, the nature of the discharge, maceration of the skin around the external mouth, the structure of the canal. General symptoms include symptoms of the underlying disease that caused the fistula - trauma, developmental defects, illness.

The examination of a patient with a fistula is based on a general plan: the patient’s complaints about the presence of a fistula, the nature and amount of discharge, the relationship with food intake, acts of defecation and urination. Anamnestic data should also be taken into account - the time of occurrence of the fistula (congenital or acquired) and the cause of its occurrence. It is necessary to carefully examine the fistula, find out its location, structure (tubular or labiform), nature and amount of discharge.

Laboratory and instrumental examination of the fistula is carried out. The patient is given a solution of a dye, such as methylene blue, to drink, and the time it takes for the dye to appear from the fistula is noted. This diagnostic method helps determine the height of the fistula, which is especially important for fistulas of the esophagus, stomach, duodenum.

When examining patients with fistulas, an important place is occupied by radiological methods - fistulography. In this case, a liquid contrast agent is injected through a thin catheter inserted into the fistula and X-rays are taken. Radiographs determine the location and direction of the fistula, the presence of leakage, show the organ from which the fistula emerges, its level and possible pathological changes in its wall.

If a fistula of internal organs is suspected, an X-ray contrast examination of the esophagus, stomach, small and large intestines should be performed. For this purpose, barium or another radiopaque substance is introduced into the cavity of these organs and its exit through the wall of the organ into the surrounding cavities or out is determined.

Today, endoscopic research methods, such as gastroscopy, colonoscopy, cystoscopy, etc., are widely used to diagnose fistulas and clarify their location and size. In some cases, internal fistulas can be discovered during an operation performed for a particular disease.

Treatment of fistulas

Treatment of patients with external fistulas is based on the following principles:

local therapy;
general therapy;
surgical therapy.

Local therapy- this is wound treatment, protection of surrounding tissues from the action of discharge from the fistula. To do this, physical means are used - various ointments, pastes, powders, which are applied at the outer opening of the fistula to prevent skin contact with the discharge from the fistula and to promote the adsorption of the discharge. Also used chemicals, the purpose of which is to prevent skin irritation by neutralizing enzymes in fistula secretions. For this purpose, inhibitors of proteolytic enzymes (contrical, gordox, etc.) are used.

Mechanical methods of skin protection are aimed at significantly reducing or stopping discharge from the fistula using special devices. To sanitize purulent fistulas, constant rinsing with a solution is carried out antiseptics. Granulating tubular fistulas can close on their own after eliminating the cause that supports them - removal of the ligature, bone sequestration and cessation of discharge from the fistula. Labial fistulas never close on their own and require surgical treatment - excision of the fistula, suturing the entrance hole in the organ, and sometimes resection of the organ.

Artificial fistulas are formed to improve the patient’s condition in order to provide him with nutrition or release contents or secretions from the organ. These fistulas can be temporary or permanent. Temporary fistulas are closed surgically after the patient’s condition improves. Internal artificial fistulas are interorgan anastomoses and are superimposed on long time or for life.

A breast fistula is a pathological channel that connects breast tissue to the environment. Such formations can be a consequence of acute mastitis and others, most often infectious diseases. They bring a lot of anxiety and inconvenience to a woman and often require long-term treatment, including surgical treatment. What are the signs of the disease and how to prevent pathology?

Read in this article

What is a fistula

A fistula, also called fistula, is an artificially formed connection between an organ and the environment. Most often, such channels are formed as a result.

There are external and internal fistulas. The first connect an organ or pathological focus with the environment. This means that at one end they reach the surface of the skin. Internal fistulas connect two hollow organs, for example, the stomach and some part of the intestine, or the bile ducts and the colon, etc.

They can also be divided into congenital and acquired. As for fistulas of the mammary glands, they are all of a pathological nature and are formed as a result of some infectious process or as a complication of treatment.

The inside of fistulas can be covered various types tissues, on which their ability to self-heal or other type of therapy depends.

Such formations are unpleasant because the contents of one organ constantly end up in another or on the surface of the body. For example, fistulas of the mammary gland most often communicate with the external environment, and pus, milk, sanguineous contents, etc. are released through the canal. All this, in addition to cosmetic and hygienic discomfort, brings a lot of inconvenience to a woman.

Reasons for appearance

Breast fistulas are a serious condition that requires competent specialist tactics. Self-medication can lead to a chronic relapsing course of such formations. The following main types of breast fistulas can be distinguished:

purulent and milky, the latter appear with continued lactation in a woman, as a rule, this is a complication of the treatment of mastitis;
after undergoing surgery;
in the presence of oncological pathology of the mammary glands;
with tuberculous lesions of breast tissue;
as a variant of the course of actinomycosis of the mammary gland.

Most often you have to deal with fistulas after chemotherapy and radiation therapy for malignant breast diseases. With this type of treatment, tissues sharply reduce their potential for regeneration, which leads to delayed healing of any wound surfaces. As a result, fistulas form. The discharge from the canal is most often serous, but when an infection occurs, it can become purulent in nature with a yellow or greenish tint.

It is also not uncommon for fistulas to form after surgery. For example, after installing . Incorrectly selected surgical material (most often threads), incorrect incisions can lead to abnormal healing with the formation of similar passages.

During treatment of mastitis

Fistulas also form during surgical treatment. Most often, this complication appears at the stage of abscess formation. According to statistics, about 5 - 10% of all operations for mastitis have such consequences. Sometimes, even with proper technique, fistulas can form.

But still, in most cases, they appear due to incorrectly chosen surgical tactics, when the surgeon replaces radial incisions with others. As a result, the ducts are dissected, which subsequently do not grow together. The secreted milk or its mixture with pus, constantly seeping out, forms a false passage.

The following points provoke the formation of fistulas in the mammary glands during surgical treatment of mastitis:

Untimely opening of abscesses, which leads to the formation of channels through which pus comes out on its own.
Incomplete removal of necrotic tissue at the site of inflammation. Subsequently, the pathological process continues to occur there, pus is formed again, which forms a “exit” for itself.
Careless, rough treatment of the breast wound during dressings and the use of tight tamponade. The gauze bandage should be placed without damaging healthy tissue, using surgical instruments. Tampons should be installed in the form of an accordion, and not tightly packed into the wound. All material should also be removed by first soaking it with hydrogen peroxide. It is better if the dressings are performed by an operating surgeon who knows all the nuances and precautions.

Watch the video about problems with mastitis:

Actinomycosis of the mammary glands

A fistula in the mammary gland is one of the manifestations of actinomycosis of the breast. This is a type of visceral mycosis, but as such has no relation to fungi. Caused by actinomycetes, special bacteria. The pathology is characterized by the constant (if not treated) formation of ulcers, abscesses of various sizes in the mammary glands with the formation of fistulas.

In most cases, other foci affected by actinomycetes are also found in the body. For example, caries, chronic tonsillitis and others.

Pathogens can enter the mammary gland tissue through damage to the skin in the breast area, most often the nipple. Hematogenous spread of actinomycetes is also isolated. In this case, we are talking about a generalized infection, in 80% of cases with damage to the lungs and tissues (ribs, muscles) of the anterior chest.

Breast tuberculosis

Often breast tuberculosis is hidden under the mask of other tumors. Sometimes the disease occurs in an ulcerative-necrotic form. In this case, tuberculous granulomas form in the mammary glands, their necrosis occurs, and creamy pus comes out through the resulting fistula.

In addition to pain, discomfort and the presence of formation, the woman notes general symptoms intoxication – weakness, sweating, possible low-grade fever.

Signs and symptoms

In 95% of cases, the mammary gland fistula has a connection with the environment, i.e. it opens to the surface of the skin. Therefore, during its formation, a woman notices the appearance of a wound from which a secretion periodically or constantly appears. It can be pus, milk, serous fluid, or contain blood impurities. On the eve of the appearance of a fistulous external tract, a woman may be bothered by the following symptoms:

pain of a throbbing, bursting or aching nature;
temperature rise up to 38 - 39 degrees;
enlargement of regional (axillary) lymph nodes, they are painful on palpation;
the skin over the pathological focus changes, it becomes hyperemic or bluish, hot to the touch;
General symptoms of intoxication may be present - weakness, lethargy, headache, dizziness, etc.

The clinical picture also largely depends on the result of what pathological process a fistula has formed.

So, if some kind of surgical treatment(about a tumor, mastitis, etc.), then most likely the formation of a fistula will be associated with this.

Actinomycosis in most cases has a bright clinical picture with damage to many organs. Most often, there are many fistulous tracts on the surface of the mammary gland. The skin of the chest has a bluish tint.

Treatment

A fistula of the mammary gland, treatment of which must begin immediately upon detection, can bother a woman for years without adequate and correct tactics or without identifying the true causative agent.

If there is even a slight discharge from the fistula tract, it is imperative to microbiological examination material. Treatment tactics largely depend on this.

For mastitis

Most often in this situation, the doctor deals with purulent or milk fistulas. Moreover, there is no need to worry if immediately after the operation a woman notices the flow of milk into the wound. This cannot be called a fistula; the condition goes away gradually as the wound heals. It is also always recommended to continue lactation. If this is not possible, you can completely stop milk production using medications.

Fistulas with mastitis have the most favorable course and in most cases heal without the need for repeated surgical treatment.

First of all, it is assigned antibacterial therapy taking into account pus cultures. It is also mandatory to add antispasmodic, analgesic, and anti-inflammatory. Correct and careful dressings are important. It is careful treatment of breast tissue that will prevent the progression of the disease and promote rapid healing.

For tuberculosis

Only in 50 - 60% of cases of tuberculosis is the correct diagnosis initially established. This is due to the latent and asymptomatic course of the pathology. It happens that tuberculosis is established only after surgical treatment and subsequent microscopic examination of the material by histologists. This complicates the course of the pathology.

Therefore, therapy for mammary tuberculosis, especially with the formation of fistulas, is most often long-term and includes several stages:

Firstly, this is drug treatment. The course can be extended over several months and even years.
Secondly, the need for surgical treatment, including repeated surgery, is always discussed.

The fact is that tuberculous scars in the mammary glands very often undergo further malignancy. That is, within 5 to 10 years, cancerous tumors form in this place, which cannot always be diagnosed in time. That is why doctors often resort to radical treatment - removal of the mammary gland, sometimes only part of it. In the future, plastic surgery can be performed to eliminate the cosmetic defect.

For actinomycosis

Treatment of actinomycosis also begins with antibacterial treatment. At the same time, the woman’s immune status is corrected, and physiotherapeutic approaches are used (UVR, UHF and others).

If the disease does not respond to conservative treatment or progresses, the question arises of surgical excision of the fistula tracts. In this case, before performing the intervention, a special contrast study is carried out to identify all kinds of passages in order to remove them all. In some cases, sectoral or total resection (removal) of the mammary gland is performed.

For cancer

Fistulas are difficult to treat after chemotherapy and radiation therapy. But operations in these cases are rarely performed. Most often, this is long-term symptomatic therapy with the use of antibacterial, antiseptic, wound-healing and anti-inflammatory agents.

In other cases

If a fistula appears after breast surgery (during the installation of implants or during other procedures), then in most cases they heal within a month or two with conservative therapy (anti-inflammatory, etc.).

Prevention

Prevention of the formation of fistulas in all cases comes down to the prevention of diseases in which they appear. General recommendations are of the following nature:

Hygienic measures should be observed and chronic foci of infection should be sanitized in a timely manner.
During breastfeeding should not be allowed. If pathology occurs, it is better to consult a specialist rather than self-medicate, which can aggravate the situation.
When performing any surgical interventions, all surgeons' recommendations should be followed.
All women need to monitor their health and immunity, since in most cases fistulas develop against the background of decreased protective forces body.

Is it necessary to interrupt breastfeeding during treatment?

If a fistula occurs during lactation, the question naturally arises whether it is possible to continue feeding the baby further.

The most correct answer to this question can only be given by a specialist on an individual basis. It is clear that the accumulation of milk will aggravate the clinical picture and interfere with healing. Therefore, it will be necessary to choose one of the options: actively express, feed the baby with two mammary glands, or stop lactation with medications.

In the case of tuberculosis and actinomycetes, there is a clear ban on breastfeeding.

Fistulas of the mammary glands are a pathology that requires an individual and competent approach to treatment. Only accurate diagnosis and coordination between the patient and the doctor will help get rid of this problem and prevent any complications in the future.

The chronic course of the inflammatory process or limited suppuration of soft tissues may be accompanied by the formation of a hollow canal connecting the pathological focus with the outer surface of the skin. Through such fistula purulent masses and granulations are periodically released.

Cancer is malignancy, which consists of atypical cells of the body that are in the phase of active and uncontrolled division.

Can a fistula turn into cancer? directly depends on the primary disease and the possibility of its malignant transformation. In such cases, as a rule, we are talking about chronic paraproctitis. This disease is characterized purulent inflammation soft tissues that surround the rectum. The development of this pathology is accompanied by the formation of deep intestinal fistulas that open on skin crotch.

Fistula as a precancerous condition: symptoms and manifestations

Initially, the patient may notice in the area anus a fistula opening from which clear liquid or purulent masses are periodically released. The disease is accompanied by intense itching and superficial dermatitis. Also, against the background of reddened skin, the patient notes the presence of an unpleasant odor.

Pain syndrome is also considered one of the manifestations of pathology. The intensity of pain depends on the patency of the fistula canal.

The disease has an undulating course with periods of exacerbation and remission. It is in the acute phase that the maximum manifestation of pain and itching occurs.

Diagnosis of this pathology consists of clarifying the patient’s complaints, visually examining him and conducting a series of instrumental studies. In stationary conditions, the patient undergoes probing of the pathological canal, ultrasound diagnostics and radiography.

Treatment methods for rectal fistula

Therapy for purulent paraproctitis consists exclusively of surgical intervention. The operation is not recommended during the period, since at this time it is very difficult to detect the exact coordinates of the fistula and the primary purulent focus.

Radical intervention is planned to be carried out in the acute phase, when opening of the fistula is observed. When the process worsens, the surgeon opens the contents of the abscess and prescribes a course of antimicrobial agents and physical therapy.

Immediately after surgical opening of the abscess, specialists begin excision of the fistula. During surgery, some patients require suturing of the rectal sphincter or mucomuscular flap.

Selecting a specific surgical technique The operation depends on the location of the fistula and the purulent focus. Often after surgery, the doctor resorts to repeat examination of the rectal area. This is necessary to clarify the complete removal of all pathological tissues.

Under what conditions can a fistula turn into cancer?

Malignant degeneration of a fistula neoplasm can occur under the following conditions:

Long-term course of purulent paraproctitis.
Lack of specific treatment for chronic inflammation of the soft tissues of the perineum.
Frequent relapses after radical intervention.
Genetic predisposition.
Permanent trauma to the colorectal area.

Signs of cancerous transformation of the fistula

The most striking symptom of malignant degeneration is the discharge of bloody contents from the fistula opening. Subsequently, an increase in pain and deterioration is noted general well-being. On late stages Oncology causes severe damage to the body.

Prevention of degeneration into cancer

In most clinical cases, timely diagnosis and radical intervention lead to a complete and lasting recovery of the patient. That is why many experts are inclined to have a favorable prognosis for the disease.

The exception is advanced and long-term untreated purulent paraproctitis. In this case, the affected area can become overgrown with scar tissue, which provokes frequent relapses and ineffectiveness surgical method. For such patients, the prognosis is relatively positive. These patients should be periodically examined by a proctologist to prevent relapses and cancerous degeneration. Patients should also remember that fistula turns into cancer mainly in the absence medical care and therapy.

The cause of such fistulas is necrosis and purulent melting of the milk ducts. The discharge of milk from a wound during dressings, which disappears after a few days, cannot be considered a milk fistula.

Damage to the milk ducts is of great importance due to improper surgical treatment of mastitis, especially with technical errors in choosing the direction of the incision. When analyzing a large number of observations, it was revealed [Shakur P.P., 1976] that the least number of milk fistulas (4.7%) developed in the group of patients who had small radial incisions with active aspiration of pus and tamponade of the wound with tapes from heterogeneous iodoform peritoneum.

Promotes the appearance of fistulas high blood pressure in the milk ducts, which is more common with tight wound tamponade. Such tamponade can cause the formation of a milk fistula.

Such a fistula is characterized by the presence of dense edges with a formed hole in the milk duct. Milk fistulas most often heal on their own. In some cases, as a result of scarring (along the duct and at its terminal end), retention mammary cysts arise.

Treatment of fistulas begins with conservative methods. For superficial localization of fistulas, cauterizing agents (lapis, iodine) can be used. Surgery is rarely resorted to.

Prevention of the formation of milk fistulas consists of timely opening of mastitis or excision of the affected sector of the mammary gland and careful handling of tissues during intervention. Tampons should be inserted gently, using long anatomical tweezers, to the deepest part of the wound, filling the entire cavity and placing them in the form of an accordion.

You need to remove the tampon slowly, after soaking it in a 3% solution of hydrogen peroxide. On the 2nd - 3rd day, the usual tamponade should be replaced with balsamic (vinrlin) or enzymatic proteolytic dressing. Patients should be advised to continue breastfeeding.

"External and internal fistulas"

Ed. E.N.Vantsyan

Consult your doctor before following any advice.

Fistula on the chest

but Love protects from old age"

A fistula is an inflammatory canal characterized by the formation of purulent discharge. A canal is formed only when there are no other ways for purulent clots to exit. Almost no person is immune from the formation of fistula canals. However, today there are a number effective methods aimed at treating and preventing this phenomenon.

Causes of fistula

Considering the reasons for the formation of fistula canals, we can divide this phenomenon into two ways of occurrence:

Congenital fistula is most likely an abnormal phenomenon, a consequence of improper development and activity of the body. Often a congenital fistula forms in the neck area, and can also form near the navel.

Acquired fistula is a consequence of the inflammatory process. This formation can also be caused by surgery. In turn, acquired fistulas are classified into external and internal.

External fistulas extend to the surface of the skin, for example, a rectal fistula. With the development of an internal fistula, the tubule nodes do not come into contact with the external environment, but form inside the tissues, for example, a bronchoesophageal fistula.

Umbilical fistula is common in infants. This pathology can be detected even at the stage of pregnancy, during an ultrasound.

An abscess rupture can lead to an anal fistula. This is a fairly common occurrence and proper treatment The fistula is eliminated in a couple of weeks. However, this is not always practiced quick way removal of the fistula. In a more complicated form, the anal fistula stretches, and the treatment time reaches several years.

A rectovaginal fistula is formed during pathological childbirth. This can be a protracted labor, postpartum trauma, which can lead to the formation of a rectovaginal fistula. Often during childbirth, surgical intervention is necessary, which can also cause the development of pathologies in the expectant mother.

A pararectal fistula is a tubule that connects the source of the disease with any part of the body or with an internal organ. Often, fistulas of this kind are formed between two inflamed organs. Also, acute paraproctitis can contribute to the development of perirectal fistula.

A fistula on the coccyx is a common occurrence in men who are characterized by abundant hair. Trauma in the sacral region can also provoke the formation of this type of fistula. Postoperative fistula, which is a consequence of impaired blood circulation, is common. The formation of a fistula can be caused by an infection, improperly treated sutures and wounds.

The most dangerous type of fistula is duodenal fistula. The cause of the disease can be surgical interventions based on the abdominal cavity. Often duodenal fistula is fatal.

Symptoms of a fistula

Based on the above, we can say that a fistula can affect any cavity and organ. That is why it has a very vague symptomatic picture. It all depends on the area where the pathology develops.

The first symptom indicating the formation of a fistula is a hole in the skin. The patient may also notice fluid leaking from the hole. In some cases, even the patient himself cannot explain the reason for the appearance of this hole. Often, a minor injury can lead to the development of a fistula.

As for internal fistulas, which do not appear as holes in the skin, they are a consequence chronic diseases. For example, a biliary fistula may be the result of stones in the bladder. There will be pain in the abdominal cavity, the severity depends on the volume of fluid released. Digestive disorders and general weakness of the body may also occur.

With the development of bronchoesophageal fistulas, the patient may develop bronchitis and even pneumonia.

The patient will not be able to detect an internal fistula on his own. Only a qualified doctor, after conducting a series of tests and examinations, will be able to determine the exact cause of such symptoms in a patient.

Diagnosis of fistula

A doctor can diagnose a fistula without any problems, only if the patient has an external fistula. Here he carefully examines the patient, identifying the amount of fluid released from the hole. The cause of the fistula should also be identified. It should be understood whether trauma or surgical intervention caused the formation of fistulous tubules.

With the development of internal fistulas, the size of the canal and the level of organ involvement should be considered. Without a special examination, it is impossible to understand in which organ the fistulous growth occurred. Often, radiography, probing, endoscopy and ultrasound are used for diagnosis.

Treatment of fistula

When considering the issue regarding the treatment of a fistula, it is necessary to understand that the only way to eliminate the pathology is surgical intervention. As for the development of the fistula canal, you should contact a specialized specialist who will assess the severity of the situation and be able to select a number of effective methods on the path to recovery. For example, if there is a gum fistula, then the dentist should treat the purulent canal.

It is necessary to begin treatment of the fistula duct immediately after identifying a hole in the skin. You should not be afraid of doctors and wait until the wound resolves itself. It can be confidently stated that purulent channel Not only will it not disappear on its own, but it can also stretch to cover new areas. And in this case, you may need to consult not with one specialist, but with several doctors who will assess the scale of the fistulous lesion.

In some cases, the formation of a fistula canal does not cause any painful sensations and discomfort. However, surgical intervention is still necessary; the fistula canal should be removed. Otherwise, purulent lesions can affect other organs, and the affected area can also include joints, kidneys, and heart. Cases have been identified in which a fistula was the cause of tumor formation.

When treating a fistula, anti-inflammatory therapy is also used, especially when it comes to purulent discharge.

Prevention of fistula

The most important thing in preventing fistula is preventing the development of infectious diseases. Considering the above reasons for the development of a fistula, we can say that the operations performed often lead to the development of a fistula canal. This suggests that it is necessary to comply with all the recommendations and requirements of doctors regarding the postoperative behavior of the patient. You should not neglect hygiene measures, but perform dressings in a timely manner, as well as follow a special postoperative diet.

The most common is gum fistula. Most people, despite the use of the latest equipment and painless methods of dental treatment in medicine, are still afraid to go to the dentist. This neglect causes the appearance of fistula ducts.

You should also monitor your immunity. It is immune weakening that leads to the development of many diseases. Infectious bacteria entering the body can lead to internal fistulas, and they can be extremely difficult to identify.

Attention to your health and nutrition are the main measures to prevent fistula.

What does a fistula look like in the photo?

Fistulas arise as a result of inflammatory processes in the internal organs, infection of wounds or the formation of purulent abscesses in the root areas of the teeth. The body tries to find a way out for the contents of the inflamed cavity in the form of a narrow channel that appears on the surface of the skin or mucous membranes, from which pus constantly oozes. Fistulas cause a lot of inconvenience, which are very difficult to get rid of.

How and why does a fistula appear?

How and why a fistula appears

Externally, a fistula looks like a pimple or an abscess, but in structure and function, fistulas are quite complex formations that connect organs and cavities with each other or with the surface of the skin using an epithelium-lined canal.

Most often, dental fistulas occur as a result of advanced periodontitis, improper filling or poor-quality treatment of caries.

A fistula is found on the gum or facial skin at the site of the projection of a diseased tooth, exuding ichor and pus. Pathogenic microflora of purulent discharge from the oral cavity penetrates the digestive organs, disturbing the balance of microflora in them, provoking dysbacteriosis. The tissues next to the diseased tooth are also affected, but the main problem is the constant presence of a source of infection in the body.

Fistulas are acquired due to developing disease and congenital, as a result of a developmental abnormality that can be determined by ultrasound of the fetus or immediately after birth. Usually, an umbilical fistula is discovered when the umbilical cord is cut off, and a neck fistula is discovered when examining a newborn.

What are the types of fistula?

Acquired fistulas vary depending on the location: external ones come to the surface of the skin, while internal ones do not have access to the external environment, but penetrate into other organs and cavities. For example, blockage bile ducts a stone can provoke the appearance of a fistula, which removes accumulated bile into the peritoneum; a fistula formed between the bronchi and the esophagus throws food particles into the respiratory tract.

Not only pus and mucus can be released from a fistula, but also urine, feces, bile and other contents, depending on the affected organ from which the fistula was formed. This is how fistulas are distinguished: gastric, intestinal, esophageal, anal, rectovaginal (a consequence of difficult and prolonged labor).

The greatest threat is posed by a fistula extending into the peritoneum from the duodenum.

In men, as a result of injury, a cyst filled with pus sometimes appears in the coccyx area, from which a fistula breaks into the intergluteal region. Postoperative fistulas, unfortunately, are too common; they arise due to improper suturing or infection of the postoperative wound.

Brief characteristics of fistulas

Very often, fistulas form after surgical operations. Many doctors immediately warn about them possible emergence and show what the fistula looks like in the photo. In my own way appearance it is practically no different from a large abscess, but in its structure it is a slightly different formation, which can lead to a number of complications if it is not treated and no attempt is made to get rid of the fistula.

The fistula in the photo may seem quite harmless, especially if it is not yet conductive, i.e. no pus or fluid passes through it. But the fistula is formed due to suppuration, which seeks its way and tries to escape from the body. Fistulas can be external or internal.

The fistula cannot heal on its own, since its filling – liquid or pus – always passes through it. A doctor or a patient can diagnose a fistula on his own based on the obvious signs of this phenomenon - discharge, usually of a purulent nature, and a canal system, which in a medical setting is checked by probing to clearly determine how deep it goes.

Treatment methods for fistulas

Treatment of fistulas depends on its type of origin, depth and filling. Among general principles Treatment should be divided into local, general and surgical therapy. Local therapy is the treatment of a wound, which includes regular washing and the use of antiseptics.

Some types of fistulas require only surgical intervention, such as granulating tubular fistulas.

A specialist can make an accurate diagnosis and prescribe appropriate treatment, but self-medication is not recommended even for the smallest abscess. Usually the doctor prescribes surgical treatment, because conservative methods do not eliminate the cause of the problem. Over time, a malignant tumor may develop at the site of the fistula, but the infected fistula itself can cause serious complications.

Traditional medicine offers quite effective methods eliminating symptoms of the disease. If you regularly wipe the fistula coming out with vodka mixed olive oil, and then use a cabbage leaf to pull the pus out of the canal, the fistula will calm down for a while.

The course of the disease is alleviated by a mixture of aloe juice and mumiyo, compresses from boiled St. John's wort leaves, which should be applied to the area of skin affected by the fistula. Anal and vaginal fistulas are treated with a cream made from water pepper grass and oak bark, which are mixed with melted lard. It should be emphasized that such methods can alleviate the course of the disease without eliminating the cause itself.

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Fistula, types, symptoms and treatment of fistula

No one is immune from the appearance of a fistula; this disease occurs quite often. Effective methods of treating different types of fistulas can be the methods offered by traditional medicine.

Definition of fistula

A fistula is understood as a canal formed in the process of inflammation, which is accompanied by the formation of purulent cavities. A fistula is formed when there is no other outlet for pus and is a narrow canal formed inside by epithelial tissue.

Prerequisites and types of fistulas

umbilical fistula is a congenital phenomenon and often occurs in infants

Based on the reason for its occurrence, a fistula is distinguished between acquired and congenital. Fistulas of the first type occur during an inflammatory process or as a result of surgical operations. Congenital fistulas are a developmental anomaly. As a rule, they are located on the lateral or front surface of the neck; umbilical fistula rarely develops.

Acquired fistulas can be classified according to the following criteria

In relation to the environment:

external (exiting directly to the skin - rectal fistula), internal (not communicating with the external environment - bronchoesophageal).

According to the nature of the secretion released from the fistula:

mucous, purulent, urinary, bile, feces, etc.

By type of affected organ:

gastric fistula, esophageal fistula, intestinal fistula, etc.

Navel fistula is a disease that often occurs in a newborn child or fetus. Typically, an umbilical fistula is detected during pregnancy during an ultrasound examination or immediately after cutting off the umbilical cord.

Removal of navel fistula video

An anal fistula often occurs after drainage or natural rupture of an abscess. Usually such a fistula goes away within a few weeks, but sometimes there are cases when the disease lasts for several years.

With pathological childbirth (for example, prolonged labor, perineal rupture after childbirth, prolonged anhydrous interval, postpartum injuries) a rectovaginal fistula may develop. Among the circumstances of its appearance, one can also name inflammatory processes in the postoperative wound after surgical intervention during childbirth.

A pararectal fistula is a pathological canal connecting any cavity or surface of the body with the source of the disease (abscess or tumor). In addition, a fistula of this kind sometimes forms between 2 organs. Pararectal fistula is a consequence of acute paraproctitis.

An anal fistula may be a consequence of previous tuberculosis, paraproctitis or actinomycosis of the anus.

Epithelial coccygeal duct is a disease in which a subcutaneous cyst with purulent contents is observed in the area of the intergluteal fold, in the area of the sacrum and coccyx, which can burst and form a coccygeal fistula.

A fistula on the tailbone is often observed in guys, mostly young and middle-aged, who have strong hair growth. Direct trauma in the sacrococcygeal area can provoke the formation of this type of fistula.

Postoperative fistula is formed due to impaired blood circulation in the tissues. A fistula after surgery often occurs as a result of incorrectly placed sutures or as a result of an infection. It happens that acquired fistulas occur when the tumor dissolves. As a rule, such fistulas affect a pair of nearby organs.

One of the most dangerous is duodenal fistula. Complications with this type of disease can even lead to death. Such a fistula can develop after a surgical operation affecting the abdominal organs.

Symptoms of fistulas

disorder of the digestive system - a symptom of the occurrence of bile fistula

The clinical picture of the disease is specific for various types of fistulas, depending on the location of the fistula, as well as the prerequisites for its appearance.

The main symptom of an external fistula is a hole in the skin from which a characteristic fluid is released. The appearance of a fistula can be caused by injury in this area or inflammation of nearby organs and tissues. The cause of a fistula can also be surgical intervention.

Internal fistulas are a consequence of complications of acute or chronic diseases. For example, a biliary fistula can form due to stone duct obstruction. The clinical picture in this case depends on the amount of bile released into the abdominal cavity, pain syndrome and the severity of the digestive system disorder.

Bronchoesophageal fistulas can be complicated by the constant entry of food into the tracheobronchial tree, which can in turn lead to the development of bronchitis or aspiration pneumonia.

Diagnosis of fistula

X-ray is used for more accurate diagnosis of fistula parameters

As a rule, there are no particular difficulties in diagnosing the disease. Diagnosis is based on the study of patient complaints characteristic of fistula, collection of anamnesis, type of fistula, analysis of the quantity and composition of discharged pus, with interorgan fistulas - on changes difference in the functions performed by the affected organs.

To clarify the length and direction of the fistula tract, as well as its connection with the pathological focus, probing and radiography are often used together with the introduction of contrast into the fistula go drug.

The diagnosis can be clarified by testing for the presence of hydrochloric acid. Its presence indicates the gastric location of the fistula.

Uric fistula is characterized by the presence of uric acid salts. External fistulas can be diagnosed quite easily, since they have a characteristic exit hole.

When diagnosing internal fistulas, X-ray, ultrasound and endoscopy methods are required.

Treatment of fistula

in traditional medicine, when treating a fistula, preference is given to surgical intervention

How to treat a fistula? Treatment of fistulas is surgical in nature, since conservative therapy is not able to help in this matter. Depending on the location of the disease, you should contact the appropriate specialists. It is recommended to treat fistulas immediately when they are detected.

Sometimes the patient is practically not bothered by pain, there is no urgent need for surgery. However, removal of the fistula is mandatory, since it is a source of chronic infection. Delay in treatment can lead to damage to organs such as the kidneys, heart, and joints also suffer. Often, fistulas can lead to the formation of a tumor.

Sometimes, during anti-inflammatory therapy, the cavity is cleansed of purulent discharge, which significantly facilitates the healing process. However, if the inside of the fistula tract is covered with epithelium, then independent healing does not occur. In this case, surgical intervention is performed to cut out the tissue with subsequent suturing of the canal.

Treatment of fistula with folk remedies

tincture with olive oil can heal fistula completely

How to cure a fistula on your own? To answer this question, it is worth turning to traditional medicine with its many centuries of experience. Treatment of fistula with folk remedies can be quite effective, up to full recovery.

Mix olive oil and vodka in equal quantities. Use the resulting mixture, preferably several times a day, to wipe the sore areas. After that, tie a cabbage leaf to this place to draw out the pus. The course of such procedures lasts several weeks, after which the fistula, as a rule, disappears.

Fistulas on the skin can be cured with this recipe. Mix aloe juice and mummy juice. It is worth noting that to obtain mummy juice, it must be soaked in water until a dark solution is formed. Apply a bandage soaked in this mixture to the sore spot and leave for a long time.

The fistula disease will go away even after compresses from St. John's wort. To do this, take 2 tbsp. l. St. John's wort herb, pour 1.5 glasses of water, boil. Afterwards, you must carefully strain the resulting broth. St. John's wort leaves should be placed on cellophane film and the affected area should be wrapped in this film. The compress may be hot, but that's good. After this procedure, the sore spot should be rinsed with the remaining infusion. Such procedures should be carried out until pus begins to discharge from the fistula.

Rectal fistula: treatment using folk methods. Take oak bark, a small amount of flax flowers and water pepper herb, a little lard. Grind all the ingredients and fill with melted lard. Observe the following proportions: for 1 glass of grass and bark, 2 glasses of lard are required.

Place the container with the resulting mass in the oven and heat over low heat. The process is long and can last for half a day. After this, the mixture should be cooled. Make cotton swabs, soak them in the resulting cream and apply to the sore spot. The course of such procedures takes up to 3 weeks.

The same method can be used to treat vaginal fistula.

If you have a fistula, do not panic. The most important thing is to start treatment on time, without delay.

Prevention of fistula

to prevent the appearance of fistulas, strengthen your immune system - freshly squeezed juices will help you with this

Prevention of fistulas mainly involves preventing infections. During surgical intervention, strict adherence to the rules of asepsis is necessary.

Prevention of gum fistula consists of timely elimination of all dental problems, and a set of procedures must be carried out by professional specialists. It is recommended to have a dental examination at least twice a year. In addition, with a certain frequency (at least once every few years) it is necessary to take photographs of previously treated teeth, since it is important to prevent possible damage as early as possible life.

For general prevention of fistula formation, it is necessary to maintain your immunity at the proper level.

Does the fistula turn into cancer?

The chronic course of the inflammatory process or limited suppuration of soft tissues may be accompanied by the formation of a hollow canal connecting the pathological focus with the outer surface of the skin. Through such a fistula, purulent masses and granulations are periodically released.

Cancer is a malignant neoplasm that consists of atypical cells of the body that are in the phase of active and uncontrolled division.

Whether a fistula can turn into cancer directly depends on the primary disease and the possibility of its malignant transformation. In such cases, as a rule, we are talking about chronic paraproctitis. This disease is characterized by purulent inflammation of the soft tissues that surround the rectum. The development of this pathology is accompanied by the formation of deep intestinal fistulas that open on the skin of the perineum.

Fistula as a precancerous condition: symptoms and manifestations

Initially, the patient may notice a fistula opening in the anus, from which clear liquid or purulent masses are periodically released. The disease is accompanied by intense itching and superficial dermatitis. Also, against the background of reddened skin, the patient notes the presence of an unpleasant odor.

Pain syndrome is also considered one of the manifestations of pathology. The intensity of pain depends on the patency of the fistula canal.

The disease has an undulating course with periods of exacerbation and remission. It is in the acute phase that the maximum manifestation of pain and itching occurs.

Treatment methods for rectal fistula

Therapy for purulent paraproctitis consists exclusively of surgical intervention. The operation is not recommended during remission, since at this time it is very difficult to detect the exact coordinates of the fistula and the primary purulent focus.

Immediately after surgical opening of the abscess, specialists begin excision of the fistula. During surgery, some patients require suturing of the rectal sphincter or mucomuscular flap.

The choice of a specific surgical technique depends on the location of the fistula and the purulent focus. Often after surgery, the doctor resorts to repeat examination of the rectal area. This is necessary to clarify the complete removal of all pathological tissues.

Under what conditions can a fistula turn into cancer?

Malignant degeneration of a fistula neoplasm can occur under the following conditions:

Long-term course of purulent paraproctitis.
Lack of specific treatment for chronic inflammation of the soft tissues of the perineum.
Frequent relapses after radical intervention.
Genetic predisposition.
Permanent trauma to the colorectal area.

Signs of cancerous transformation of the fistula

The most striking symptom of malignant degeneration is the discharge of bloody contents from the fistula opening. Subsequently, cancer patients note an increase in pain and a deterioration in general well-being. In the later stages, oncology causes sudden weight loss and cancerous intoxication of the body.

Prevention of degeneration into cancer

The exception is advanced and long-term untreated purulent paraproctitis. In this case, the affected area can become overgrown with scar tissue, which provokes frequent relapses and the failure of the surgical method. For such patients, the prognosis is relatively positive. These patients should be periodically examined by a proctologist to prevent relapses and cancerous degeneration. Patients should also remember that a fistula turns into cancer mainly in the absence of medical care and therapy.

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The information on the site is presented for informational purposes only! It is not recommended to use the described methods and recipes for treating cancer on your own and without consulting a doctor!

Are the mammary glands affected by ulcers? Finding out the reasons

Actinomycosis, which affects the mammary glands, is not directly related to fungal diseases, since radiant actinomycete fungi are simply morphologically similar to the causative agents of mycoses, but are actually considered bacterial cells. Accordingly, the course of the disease in the absence of timely treatment will be severe, with a progressive purulent process, often leading to the need for surgical intervention, including resection of the mammary gland. Timely identification of the causative agent of actinomycosis and careful long-term antibiotic therapy will help maintain breast health and the patient’s ability to work.

Why does breast actinomycosis develop and how does it manifest?

Actinomycosis of the mammary glands usually develops against the background systemic damage body. The pathogen can enter the breast tissue through nipple cracks or skin lesions, or can be introduced as a secondary infection from another source - for example, from carious teeth, inflamed pharyngeal tonsils or affected lungs.

With actinomycosis, both mammary glands are not necessarily affected at the same time, although this also happens. Having penetrated the breast tissue, the pathogen forms a granuloma nodule at the site of its penetration, which is externally manifested by hyperemia and swelling of the skin of the chest. Next, new nodules form around it, prone to merging with the focus of purulent lesions. The process either spreads upward along the fiber, and an opening occurs with the formation of fistulas, or causes destructive changes with proliferation connective tissue mammary gland.

When visiting a doctor, patients with actinomycosis of the mammary gland complain specifically about ulcers and painful nodules under the skin of the breast, and the skin above the maturing ulcers may have a purple color.

After opening the abscesses, fistulous tracts with purulent discharge are formed in their place. The disease is not contagious, but can drag on for years, periodically exacerbating and progressing.

How to correctly diagnose actinomycosis and how to treat it

Traditional diagnostic methods for mammology, such as ultrasound or mammography, are not informative for actinomycosis of the breast. The diagnosis, made on the basis of an initial examination and the discovery of many fistulous tracts in the mammary gland, from which pus is released when squeezed, is confirmed by bacteriological culture.

The peculiarity of the treatment of actinomycosis of the mammary gland is the duration of antibiotic use (sometimes several months), actinolysates are prescribed, drugs to strengthen the immune system, and vitamins are recommended. Abscesses and fistulous tracts must be opened and cleansed of purulent masses. If antibacterial therapy is not successful, sectoral resection is possible, and if there is a complication in the form of a total purulent process, mastectomy may be necessary. Most often, actinomycosis of the breast has a favorable prognosis, but it negatively affects the patient’s social adaptation; recovery can be followed by relapses, and therapy is required for many years.