Perianal abscesses and fistulas

Publisher Website
Google Scholar
Abstract
In a 5 1/2 yr period, 1023 patients with anorectal abscesses and fistulas were treated. Under regional anesthesia the abscesses were unroofed and debrided and a primary fistulotomy was performed whenever a low fistula was identified. In 355 (34.7%) an internal fistulous opening was demonstrated at the time of abscess drainage. Patients (32) had suprasphincteric fistulas and underwent 2-stage fistulotomy using a seton. Perianal abscesses were encountered in 42.7% of the patients, followed by ischiorectal (22.7%), intersphincteric (21.4%), and supralevator (7.33%). The patients with supralevator and intersphincteric abscesses had a high incidence of fistula identified during abscess drainage. The recurrence rates were 3.7% in the group with abscess drainage only and 1.8% in the group that had primary fistulotomy along with abscess drainage. The follow-up period averaged 36 mo. To accomplish adequate drainage and identify the deeper components and associated fistulous opening (34.7% of the entire group), careful examination under regional anesthesia is recommended. Early aggressive treatment of an anorectal abscess and fistula significantly reduces the possibility of recurrent abscesses and/or the need for further surgery.

This publication has 11 references indexed in Scilit: