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[Anorectal abscess and fistula]
1Chirurgische Klinik, Stadtspital Waid, Zürich.
Therapeutische Umschau. Revue Therapeutique
|April 1, 1997
Summary
Anal glands are crucial in developing abscesses and fistulas. Treatment varies by abscess type: perianal abscesses are opened, while intersphincteric abscesses and fistulas may require fistulotomy or mucosa flap techniques.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Anatomy
Context:
- Anal glands, located in the intersphincteric space at the dentate line, are primary sites for abscess and fistula development.
- Secondary causes include inflammatory colorectal diseases and skin infections.
- Advances in diagnostic tools are improving the identification of anorectal conditions.
Purpose:
- To propose a simple and practical nomenclature for classifying anorectal abscesses and fistulas.
- To describe the clinical presentation and diagnostic approaches for these conditions.
- To outline current treatment strategies based on abscess and fistula location.
Summary:
- Perianal abscesses are best treated by simple drainage, while intersphincteric abscesses necessitate fistulotomy.
- Perianal fistulas, occurring in 50% of perianal abscess cases, are treated with fistulotomy below the dentate line.
- Intersphincteric and supradentate fistulas are often managed with mucosa flap techniques to preserve sphincter function.
Impact:
- The proposed nomenclature aids in consistent classification and communication.
- Differentiated treatment strategies optimize outcomes for various anorectal abscesses and fistulas.
- Sphincter-sparing techniques for complex fistulas aim to minimize functional deficits.