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Related Experiment Videos

Management of intersphincteric abscesses.

M Millan1, E García-Granero, P Esclápez

  • 1Colorectal Surgery Unit, Department of Surgery, Clinic University Hospital, University of Valencia, Valencia, Spain. millanmonica@hotmail.com

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|October 13, 2006
PubMed
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Intersphincteric abscesses, particularly those with high extensions, require specific surgical approaches. Low abscesses benefit from direct drainage and sphincter division, while high abscesses often need staged procedures with a mushroom catheter for optimal outcomes.

Area of Science:

  • Colorectal Surgery
  • Surgical Management of Abscesses
  • Anorectal Diseases

Background:

  • Intersphincteric abscesses are uncommon and can pose management challenges, especially with upward extensions.
  • Effective treatment strategies are crucial to prevent recurrence and complications.

Purpose of the Study:

  • To analyze the treatment modalities employed for intersphincteric abscesses.
  • To evaluate the outcomes and recurrence rates associated with different surgical approaches.

Main Methods:

  • Retrospective review of 21 intersphincteric abscesses treated between 1992 and 2004.
  • Analysis of abscess location, extension, treatment type, recurrence rates, and use of endoanal ultrasound.

Main Results:

Related Experiment Videos

  • The majority of patients were male (90%), with a significant history of prior perianal suppuration (48%).
  • Low intersphincteric abscesses were treated by laying open and dividing the internal sphincter.
  • High intersphincteric abscesses often required staged procedures, including temporary mushroom catheter drainage.

    • Conclusions:

    • Low intersphincteric abscesses are best managed with abscess de-roofing and internal sphincter division to the dentate line.
    • High intersphincteric abscesses frequently necessitate staged surgery with a mushroom catheter.
    • Accurate ultrasound localization and appropriate drainage are vital for preventing recurrence and extrasphincteric fistulas.