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Clin Colon Rectal Surg 2007; 20(2): 102-109
DOI: 10.1055/s-2007-977488
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Perianal Abscess/Fistula Disease

Mark H. Whiteford1 , 2
  • 1Gastrointestinal and Minimally Invasive Surgical Division, Legacy Portland Hospitals, Portland, Oregon
  • 2Oregon Health and Science University, Portland, Oregon
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Publication History

Publication Date:
09 May 2007 (online)

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ABSTRACT

Perirectal abscesses and fistulas represent the acute and chronic manifestations of the same disease process, an infected anal gland. They have beleaguered patients and physicians for millennia. A thorough understanding of the anatomy and pathophysiology of the disease process is critical for optimal diagnosis and management. Abscess management is fairly straightforward, with incision and drainage being the hallmark of therapy. Fistula management is much more complicated. It requires striking a balance between rates of healing and potential alteration of fecal continence. This, therefore, requires much more finesse. Many techniques are now available in the armamentarium of the surgeon who treats fistula-in-ano. Although no single technique is appropriate for all patients and all fistula types, appropriate selection of patients and choice of repair technique should yield higher success rates with lower associated morbidity.

KEYWORDS

Abscess - fistula - perianal - perirectal - fistula-in-ano

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Mark H WhitefordM.D. 

Gastrointestinal and Minimally Invasive Surgical Division, Legacy Portland Hospitals

1040 Northwest 22nd Ave., Ste. #560, Portland, OR 97210

Email: mwhiteford@orclinic.com

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