The majority are associated with anorectal abscess formation, with one third of patients with an anorectal abscess having an associated perianal fistula at the time of presentation. The formation of an perianal fistula typically occurs as a consequence of an perianal abscess. However, other risk factors for their formation include:. Anal fistulae usually present with either 1 recurrent perianal abcesses 2 intermittent or continuous discharge onto the perineum , including mucus, blood, pus, or faeces. Figure 1 — The Goodsall rule, used clinically to predict the course of a fistula tract. Proctoscopy can be used to visualise the opening of the tract in the anal canal.
Case of anal fistula with Fournier's gangrene in an obese type 2 diabetes mellitus patient
Anorectal abscess and fistula-in-ano | HealthEngine Blog
Anorectal abscess and fistula-in-ano occur in the rectum and anus. An abscess is a localised collection of pus. In this case, it can either occur near the anus close under the skin, or deeper, adjacent to the rectum. It occurs as a complication of an ano-rectal abscess which has discharged to the skin, with the track from anorectal passage to the skin remaining patent. Perianal abscesses occur as a result of a blocked anal gland that subsequently becomes infected — and thus an abscess forms. Fistula-in-ano frequently complicates the above conditions, but it can also be idiopathic of unknown cause , or arise in patients with tuberculosis , trauma especially obstetric — after traumatic delivery , carcinoma, pelvic inflammatory disease, radiation damage post radiotherapy. Surgical treatment is, however, usually successful.
Anorectal abscess and fistula-in-ano
The primary aim of this study was to see whether perianal abscess rate differs between patients with type 1 and type 2 diabetes. A secondary aim was to determine whether poor glycemic control increases the risk for perianal abscess. The risk for anal abscess was evaluated in univariate and multivariate analyses with type of diabetes, HbA1c level, BMI, and various diabetes complications as independent factors. Patients with type 1 diabetes had a lower rate of perianal abscess than patients with type 2 diabetes when adjusted for HbA1c, sex, and age OR 0. The risk for perianal abscess increased with higher HbA1c.
There is a lack of consistent national data on the evaluation of the epidemiological profile of patients with anal fistula. To evaluate the epidemiological profile of patients with anal fistula at a center specialized in coloproctology. A cross-sectional, retrospective study was carried out between and of patients who underwent surgical procedures for the treatment of fistula in ano by the Department of Coloproctology of the Regional Hospital of Mato Grosso do Sul. Age, gender, disease duration, number of procedures, association with Crohn's disease and other comorbidities were evaluated.