Incidence of fistula-in-ano complicating anorectal sepsis: A prospective study

Henrichsen, S; Christiansen, John

doi:10.1002/bjs.1800730515

Cited by 58 publications

(24 citation statements)

References 3 publications

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“…It is important to realize that only about half of the patients realize that they have a fistula [11]. In addition a follow-up period of 1 year is too short, since in our study more than half of the clinical recurrences occurred after 1 year.…”

Section: Discussionmentioning

confidence: 91%

The Initial Approach to Anorectal Abscesses: Fistulotomy Is Safe and Reduces the Chance of Recurrences

Knoefel

Hosch

et al. 2000

Dig Surg

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Background/Aims: Anorectal abscesses are most frequently based on a coexistent fistula in ano. Whether these should be searched for and excised initially or not remains controversial. Our aim was to determine which approach has less recurrences and carries a lower risk of continence disorders. Methods: 158 patients with an anorectal abscess or anal fistula were identified in our institution over a period of 75 consecutive months. The records and follow-up questionnaires of 131 patients were evaluable. The mean follow-up period was 40 (range 3–78) months. Results: When fistulotomy was performed at the time of draining the abscess, the recurrence rate could be reduced, in comparison to incision and drainage alone, from 34 to 4% (p = 0.007). In the group of patients undergoing surgery for a recurrence, the recurrence rate could even be reduced from 67 to 0% (p = 0.03) by simultaneous fistulotomy. A total of 4 of the 131 patients (3%) developed incontinence of liquid stool and flatus, but no incontinence of solid stool occurred. Incontinence did only occur after recurrent disease. Conclusions: The number of recurrences requiring surgery can be significantly reduced by initial fistulotomy. The risk to develop incontinence increases with recurrent anorectal disease, not with careful fistulotomy.

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Section: Discussionmentioning

confidence: 91%

The Initial Approach to Anorectal Abscesses: Fistulotomy Is Safe and Reduces the Chance of Recurrences

Knoefel

Hosch

et al. 2000

Dig Surg

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“…The mean age of patients was 39.8 and it was similar to other studies. 5,12,14 Most aerobic and anaerobic organisms isolated from the PAes are of GIT and skin flora origin. 5 The isolation of anaerobic bacteria together with aerobic organism at that site is not surprising, since anaerobes are the predominant organisms in GIT where they outnumber aerobes in a ratio of 1,000:1.…”

Section: Discussionmentioning

confidence: 99%

The evaluation of bacteriology in perianal abscesses of 81 adult patients

Ulug¹,

Gedik²,

Gırgın³

et al. 2010

Braz J Infect Dis

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Objective: Treatment of perianal abscesses requires prompt surgical drainage and antimicrobial therapy. However, we should encourage the selective use of antimicrobial agents on a case-by-case basis, especially because there is no evidence that uncomplicated perianal abscesses can be safely treated only with drainage. For this reason, it is important to identify the causative organisms; therefore, we accessed the microbiological analysis of these patients. Patients and methods: In this study, 81 consecutive adult patients with perianal abscesses, who presented at a university hospital in Diyarbakir from January 2004 to December 2006, were included. Clinical and laboratory data, and results of microbiological analysis were recorded. Results: All specimens, except seven, yielded bacterial growth. Escherichia coli, Bacteriodes spp., coagulase-negative Staphylococci, and Staphylococcus aureus were the most common isolated organisms. Conclusion: In contrast to other investigators, this study demonstrated that aerobic organisms are the predominant isolates in these infections.

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“…[10][11][12][13][14][15][16] Most fistulas arise on the background of a pre-existing abscess. 17 They may also occur spontaneously and (less commonly) in the context of There is no definitive means of preventing or predicting fistula occurrence or formation after abscess drainage.…”

Section: Abscess or Fistula?mentioning

confidence: 99%