Anorectal Abscess Fistula

Hanley, Patrick H.

doi:10.1016/s0039-6109(16)41532-x

Cited by 27 publications

(9 citation statements)

References 9 publications

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“…On the other hand, abscesses perforating the external anal sphincter anteriorly or posteriorly enter the preanal or postanal spaces [3], in which situation the internal opening may be identified on the anterior or posterior midline at the level of dentate line. If the abscesses are not drained either surgically or spontaneously at this stage, they spread extensively into the ischiorectal spaces [6]. This pattern of spread results in anterior and posterior horseshoe abscesses.…”

Section: Discussionmentioning

confidence: 99%

“…As observed in all patients presented, the presence of internal opening on the posterior midline at the level of dentate line dictates the presence of associating deep postanal space abscess. If this abscess is not drained, the definitive treatment of fistula cannot be achieved [6]. This is the most important point in the surgical treatment of posterior horseshoe fistulas.…”

Section: Discussionmentioning

confidence: 99%

“…This pattern of spread produces anterior and posterior horseshoe abscesses which further result in horseshoe or semi-horseshoe fistulas [5]. Chronic abscess fistulas may become quiescent and may recur as an acute abscess with the formation of a new tract and secondary opening [6]. Treatment should involve opening the deep postanal space by a posterior midline incision which separates the superficial external sphincter muscle into halves, severing the subcutaneous external sphincter and the lower edge of the internal sphincter and unroofing the tracts by fistulotomy as first described by Hanley [7].…”

Section: Introductionmentioning

confidence: 99%

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Fistulotomy and drainage of deep postanal space abscess in the treatment of posterior horseshoe fistula

Inceoglu

Gençosmanoğlu

2003

BMC Surg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fistulotomy and drainage of deep postanal space abscess in the treatment of posterior horseshoe fistula

Inceoglu

Gençosmanoğlu

2003

BMC Surg

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“…The presence of polymorphonuclear leukocytes in 116 cases, however, indicates continued activity of the inflammatory process, but frank suppuration or an abscess was seen in only 13 cases. The presence of an abscess has been reported more frequently by other workers [16], leading to the conclusion by some that the abscess is an antecedent of FIA [2,13,17].…”

Section: Discussionmentioning

confidence: 98%

Fistula-In-Ano: A Pathological Study

et al. 1991

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A review of 229 cases of fistula-in-ano in our institution has shown that nonspecific inflammatory tissue lines the majority of tracts. Epithelial lining was present in 50 cases and was encountered proportionately more frequently in subjects under 10 years of age, thus supporting a congenital origin as well as infection of anal glands, earlier proposed by other workers. Intestinal contents may have a role in the foreign body response seen in many cases. Locally endemic infectious conditions do not appear to play a significant role in the cause of the disease.JT Anim, SA Sowayan, CS Grant, H Al-Breiki, Fistula-In-Ano: A Pathological Study. 1991; 11(4): 377-380 Fistula-in-ano (FIA) is a disease that has been recognized since early times, but in spite of detailed early descriptions, our understanding of its pathogenesis is still unclear. The current consensus of an underlying infection of anal glands was first proposed by Herman and Desfosses in 1880 [1], and subsequently reinforced by other workers [2][3][4]. Since then, various clinicopathological aspects of the disease have been studied [5][6][7][8].A review of local Arab medical literature has yielded only a few reports on FIA, most clinical, with emphasis on management [9][10][11]. This paper is a review of all cases seen in the pathology department of our hospital. Material and MethodsAll surgical specimens of FIA submitted to the pathology department of King Fahd Hospital of the University, Al-Khobar (KFHU), over the five-year period January 1984 to December 1988, were included in the study. The age and sex of the patients were obtained from the request forms. Hematoxylin and eosin slides were reviewed by two pathologists. Available special stains reviewed included: Ziehl-Neelsen stain, periodic acid-Schiff reaction, and Gram and Giemsa stains. Histological parameters examined included the presence and type of epithelium lining the fistulous tract, the type of the inflammatory response, granuloma formation, and presence of a foreign body. Organisms specifically looked for were: acid-fast bacilli, fungi, Schistosoma ova, and Leishmania organisms. No attempt was made to quantitate the histological features, although their interrelationships and possible relationship to pathogenesis were observed. ResultsA total of 248 FIA specimens were seen in our laboratory during the five-year period. Nineteen specimens were adjudged unrepresentative and excluded from further study. Table 1 summarizes the age distribution of the remaining 229 FIA cases and shows a peak incidence in the fourth decade. There were 209 (91.3%) males versus 20 (8.7%) females, yielding a sex ratio of 10.5 males to 1 female.Partial or complete epithelial lining of the tract was observed in 50 cases (21.8%). Columnar epithelium similar to that lining the anal glands was the most common (Table 2), indicating the involvement of anal glands in the formation of FIA. Squamous epithelial lining, in combination with columnar, was found in the depths of the FIA in 10 of 50 cases (20%). Five of the 50 pa...

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“…Although infected anal glands are the most common cause of suppurative disease in this area, in the differential diagnosis one must consider infected presacral epidermoid inclusion cysts, infected sebaceous cysts, hydradenitis suppurativa, foreign bodies, Crohn's disease, and Bartholin gland abscesses (Hanley, 1978).…”

Section: Introductionmentioning

confidence: 99%

Anorectal abscesses: Need for accurate anatomical localization of the disease

Nomikos¹

1997

Clin. Anat.

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Anorectal abscesses constitute a common problem of the perianal area. Considerable morbidity is expected if an immediate and anatomically correct drainage procedure is not performed in a timely manner. Acute infection of an anal gland leads to the formation of the anorectal abscess, while the chronic stage of the infection appears as a fistula in ano. It is imperative to perform operations with accurate anatomical knowledge; this is particularly true in the case of fistula‐in‐ano and anorectal abscesses, for which inappropriate surgery can lead to disastrous results. Here we report our experience with anorectal abscesses in various locations in 14 patients. Four of the 14 had a transrectal drainage. The internal (transrectal) or external drainage of the anorectal abscesses depends mainly on the mechanism of their formation and the anatomical relationship of the abscess to the levator ani. Apart from a death occurring 1 month after drainage due to a cause not related to suppurative disease (subdural hematoma), all patients had an uneventful recovery and were discharged from hospital after a mean stay of 1.2 days. A brief and practical description of the macroscopic anatomy of the area will assist in understanding better the selection of the appropriate route of drainage of anorectal abscesses. Clin. Anat. 10:239‐244, 1997. © 1997 Wiley‐Liss, Inc.

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Anorectal Abscess Fistula

Cited by 27 publications

References 9 publications

Fistulotomy and drainage of deep postanal space abscess in the treatment of posterior horseshoe fistula

Fistulotomy and drainage of deep postanal space abscess in the treatment of posterior horseshoe fistula

Fistula-In-Ano: A Pathological Study

Anorectal abscesses: Need for accurate anatomical localization of the disease

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