Anorectal Abscess and Fistula-in-Ano

Martin A. Luchtefeld

doi:10.1055/s-2001-16550

Clinics in Colon and Rectal Surgery, Inhaltsverzeichnis

Clin Colon Rectal Surg 2001; 14(3): 221-232
DOI: 10.1055/s-2001-16550

Anorectal Abscess and Fistula-in-Ano

Martin A. Luchtefeld¹ ²

¹Ferguson Clinic, Grand Rapids, MI
²Department of Surgery, Michigan State University, East Lansing, MI

Abstract

ABSTRACT

Anorectal abscesses and fistulas are problems that are commonly encountered. Occasionally, their management can prove to be formidable, constantly challenging the clinical and surgical skills of the practicing surgeon.

This article reviews the etiology, presentation, and treatment of anorectal abscesses and fistulas, highlighting subtleties in their presentation and treatment. Newer imaging techniques that can be employed to aid with the management of complicated fistulas are discussed as are new techniques used to treat these fistulas.

KEYWORD

Anorectal abscess - fistula-in-ano - fistulotomy - seton - advancement flap - fibrin glue

Volltext

Referenzen

REFERENCES

1 Morson B C, Dawson I MP. Gastrointestinal Pathology. London: Blackwell Scientific 1979: 715-718
2 Seow-Choen F, Ho J M. Histoanatomy of anal glands. Dis Colon Rectum . 1994; 37 1215-1218
3 Parks A G. Pathogenesis and treatment of fistula-in-ano. Br Med J . 1961; 1 463-469
4 Parks A G, Thompson J PS. Intersphincteric abscess. Br Med J . 1973; 2 537-539
5 Goldberg S M, Gordon P H, Nivatvongs S. Essentials of Anorectal Surgery. Philadelphia: JB Lippincott 1980: 100-127
6 Scoma J A, Salvati E P, Rubin R J. Incidence of fistulas subsequent to anal abscessses. Dis Colon Rectum . 1974; 17 357-359
7 Vasilevsky C-A, Gordon P H. The incidence of recurrent abscesses or fistula-in-ano following anorectal suppuration. Dis Colon Rectum . 1984; 2 126-130
8 Beck D E, Fazio V W, Lavery I C. Catheter drainage of ischiorectal abscesses. South Med J . 1988; 81 444-446
9 Tang C-L, Chew S-P, Seow-Choen F. Prospective randomized trial of drainage alone vs drainage and fistulotomy for acute perianal abscess with proven internal opening. Dis Colon Rectum . 1996; 39 1415-1417
10 Schouten W R, van Vroonhoven T J V M. Treatment of anorectal abscess with or without primary fistulectomy: results of a prospective randomized trial. Dis Colon Rectum . 1991; 34 60-63
11 Ramanujam P S, Prasad M L, Abcarian H, Tan A B. Perianal abscesses and fistulas-a study of 1023 patients. Dis Colon Rectum . 1984; 27 593-597
12 Fucini C. One stage treatment of anal abscesses and fistulas. A clinical appraisal on the basis of two different classifications. Int J Colorectal Dis . 1991; 6 12-16
13 Vasilevsky C-A. Fistula-in ano and abscess. In: Beck DE, Wexner SD, eds. Fundamentals of Anorectal Surgery London: WB Saunders 1998: 153-173
14 Gordon P H. Anorectal abscess and fistula-in-ano. In: Gordon PH, Nivatvongs S, eds. Principles and Practice of Surgery of the Colon, Rectum and Anus St. Louis: Quality Medical Publishing 1999: 221-265
15 Hanley P H. Reflections on anorectal abscess and fistula 1984. Dis Colon Rectum . 1985; 28 528-533
16 Abcarian H. Surgical management of recurrent anorectal abscess. Contemp Surg . 1982; 21 85-91
17 Mazier W P. The treatment and care of anal fistulas: a study of 1,0000 patients. Dis Colon Rectum . 1971; 14 134-144
18 Seow-Choen F, Nicholls R J. Anal fistula. Br J Surg . 1992; 79 197-205
19 Parks A G, Gordon P H, Hardcastle J D. A Classification of fistula-in-ano. Br J Surg . 1976; 63 869-871
20 Wexner S D, Rosen L, Roberts P L. Practice parameters for treatment of fistula-in-ano-supporting documentation. Dis Colon Rectum . 1996; 39 1363-1372
21 Cirocco W C, Reilly J C. Challenging the predictive accuracy of Goodsall's rule for anal fistulas. Dis Colon Rectum . 1992; 35 537-542
22 Kuijpers J HC. Diagnosis and treatment of fistula-in-ano. Neth J Surg . 1982; 34 147-152
23 Yang C Y. Fistulotomy and marsupilization for simple fistula-in-ano. Singapore Med J . 1992; 33 268-270
24 Pearl R K, Andrews J R, Orsay C P. Role of the seton in the management of anorectal fistulas. Dis Colon Rect . 1993; 36 573-579
25 Graf W, Pahlman L, Ejerblad S. Functional results after seton treatment of high transsphincteric anal fistulas. Eur J Surg . 1995; 161 289-291
26 Garcia-Aguilar J, Belmonte C, Wong W D, Goldberg S. Anal fistula surgery: factors associated with recurrence and incontinence. Dis Colon Rectum . 1996; 39 723-729
27 Fazio V W. Complex anal fistulae. Gastroenterol Clin North Am . 1987; 16 93-114
28 Aguilar P S, Plasencia G, Hardy T G. Mucosal advancement in the treatment of anal fistula. Dis Colon Rect . 1985; 28 496-498
29 Ortiz H, Marzo J. Endorectal flap advancement repair and fistulectomy for high transsphincteric and suprasphincteric fistulas. Br J Surg . 2000; 87 1680-1683
30 Schouten W R, Zimmerman D E, Briel J W. Transanal advancement flap repair of transsphincteric fistulas. Dis Colon Rectum . 1999; 42 1419-1423
31 Golub R W, Wise Jr M W, Kerner B A, Khanduja K S. Endorectal mucosal advancement flap: the preferred method for complex cryptoglandular fistula-in-ano. J Gastrointest Surg . 1997; 1 487-491
32 Parks J J, Cintron J R, Orsay C P, Pearl R K. Repair of chronic anorectal fistulae using commercial fibrin sealant. Arch Surg . 2000; 135 167-69
33 Gordon P H, Wiens T E, Orsay C P. What's new in the treatment of complicated fistula-in-ano. Perspect Colon Rectal Surg . 1999; 1 47-61
34 Parks A G, Stitz R W. The treatment of high fistula-in-ano. Dis Colon Rectum . 1976; 19 487-499
35 Kennedy H L, Zegarra J P. Fistulotomy without external sphincter division for high anal fistulae. Br J Surg . 1990; 77 898-890
36 Bennett R C. A review of the results of orthodox treatment of anal fistulae. Proc R Soc Med . 1962; 55 756-757
37 Sangwan Y P, Rosen L, Riether R D, Stasik J J. Is simple fistula-in-ano simple?. Dis Colon Rectum . 1994; 37 885-889
38 Vasilevsky C-A, Gordon P H. Results of treatment of fistula-in-ano. Dis Colon Rectum . 1985; 28 225-231
39 Lunniss P J, Sheffield J P, Talbot I C. Persistence of idiopathic anal fistula-in-ano may be related to epithelialization. Br J Surg . 1995; 82 32-33
40 Weisman R I, Orsay C P, Pearl R K. The role of fistulography in fistula-in-ano: report of five cases. Dis Colon Rectum . 1991; 34 181-184
41 Kuijpers H C, Schulpen T. Fistulography for fistula-in-ano. Is it useful?. Dis Colon Rectum . 1985; 28 103-104
42 Cataldo P, Senagore A J, Luchtefeld M A. Intrarectal ultrasound in the evaluation of perirectal abscesses. Dis Colon Rectum . 1993; 36 554-558
43 Deen K I, Williams J G, Hutchinson R. Fistula-in-ano: endoanal ultrasonographic assessment assists decision making for surgery. Gut . 1994; 35 391-394
44 Seow-Choen F, Burnett S, Bartram C I, Nicholls R J. Comparison between anal endosonography and digital examination in the evaluation of anal fistulas. Br J Surg . 1991; 78 445-447
45 Poen A C, Felt-Bersma R J, Eijsbouts Q A, Cuesta M A. Hydrogen peroxide-enhanced transanal ultrasound in the assessment of fistula-in-ano. Dis Colon Rectum . 1998; 41 1147-1152
46 Hussain S M, Stoker J, Schouten W R. Fistula-in ano: endoanal sonography vs endoanal MR imaging in classfication. Radiology . 1996; 2000 475-481
47 Barker P G, Lunniss P J, Armstrong P. Magnetic resonance imaging of fistula-in-ano: technique, interpretation, and accuracy. Clin Radiol . 1994; 49 7-13
48 Madsen S M, Myschetzky P S, Heldmann U, Rasmussen O O. Fistula in ano: evaluation with low-field magnetic resonance imaging (0.1 T). Scand J Gastroenterol . 1999; 34 1253-1256
49 Chapple K S, Spencer J A, Windsor A C, Wilson D. Prognostic value of magnetic resonance imaging in the management of fistula-in-ano. Dis Colon Rectum . 2000; 43 511-516
50 Van Tets F W, Kuijpers H C. Continence disorders after anal fistulotomy. Dis Colon Rect . 1994; 37 1194-1197
51 Williams J G, Rothenberger D A, Nemer F D. Fistula-in-ano in Crohn's disease. Results of aggressive surgical treatment. Dis Colon Rectum . 1991; 34 378-384
52 Buchmann P, Keighley M RB, Allan R N. Natural history of perianal Crohn's disease: ten year follow-up. A plea for conservatism. Am J Surg . 1980; 140 642-644
53 Halme L, Sainio A P. Factors related to frequency, type and outcome of anal fistulas in Crohn's disease. Dis Colon Rectum . 1995; 38 55-59
54 Brandt L J, Bernstin L H, Boley S J. Metronidazole therapy for perineal Crohn's disease: a follow up study. Gastroenterolgy . 1982; 83 383-387
55 Korelitz B I, Adler D J, Mendelsohn R A. Long-term experience with 6-mercaptopurine in the treatment of Crohn's disease. Am J Gastroenterol . 1993; 88 1198-1205
56 Present D H, Korelitz B I, Wisch N. Treatment of Crohn's disease with 6-mercaptopurine. A long-term, randomized double-blind study. N Engl J Med . 1980; 302 981-987
57 Present D H, Rutgeerts P, Targan S. Infliximab for the treatment of fistulas in patients with Crohn's disease. N Engl J Med . 1999; 340 1398-1405
58 Glenn J, Cotton D, Wesley R, Pizzo P. Anorectal infections in patients with malignant diseases. Rev Infect Dis . 1988; 10 42-52