Welcome to Open Science
Contact Us
Home Books Journals Submission Open Science Join Us News
Classification of Fistula in Ano
Current Issue
Volume 2, 2015
Issue 6 (December)
Pages: 99-102   |   Vol. 2, No. 6, December 2015   |   Follow on         
Paper in PDF Downloads: 34   Since Nov. 3, 2015 Views: 1593   Since Nov. 3, 2015
Authors
[1]
Saadeldin Ahmed Idris, Dept. of Surgery, Faculty of Medicine, Alzaeim Alazhari University, Khartoum, Sudan.
[2]
Arafa Eltayeb Hassan Abdalla, Dept. of Surgery, College of Medicine, University of Sciences and Technology, Khartoum, Sudan.
[3]
Aamir Abdullahi Hamza, Dept. of Surgery, Faculty of Medicine, Bahri University, Khartoum, Sudan.
Abstract
Background: Classification of perianal fistulae and knowledge of its anatomy are particularly important in determining the appropriate medical and surgical therapy. Aim: To identify the patterns of fistula in ano (FIA) in our local population. Patients and methods: A prospective multicentric, hospital-based study (November 2013 to November 2014), included all patient presented with the clinical diagnoses of FIA. Patients with preexisting condition that might predispose to abscess formation or development of fistulae were excluded. Fistulae were classified using Parkʹs classification depending on its location in relation to the anal sphincter muscles and the simplest system of classification of perianal fistulae that divides fistulae into either low or high depending on their relationship to the dentate line. The collected data was analyzed statistically using a computer program Statistical Package for Social Sciences (SPSS) version 19. Results: One hundred and six patients were included (97 males and 9 females), with male to female ratio of 10.7:1. Their mean age was 35.63±12.33 years. Presentation was variable and the commonest was anal discharge that observed in 105 (99.1%) patients. The mean duration of symptoms was 7.60±10.23 month. Previous perianal surgery was found in 17 (16.04%) patients in form of abscess drainage. Diagnosis confirmed by perianal examination, digital rectal examination (DRE), and proctoscopy or sigmoidoscopy. Magnetic resonance image (MRI) was not performed as a tool of investigation. Using Parkʹs classification intersphincteric FIA was seen in 75.5%. Depends on simplest system of classification it was low type in 95.3%. Conclusion: Fistulae in ano classification is important because the treatment differs between different types of fistulous tracks.
Keywords
Fistula in Ano (FIA), Presentation, Diagnosis, Classification
Reference
[1]
Phillipo L. C., Joseph B.M. Fistulectomy versus fistulotomy with marsupialisation in the treatment of low fistula-in ano: A prospective randomized controlled trial. Tanzania Journal of Health Research 2013; 15(3).
[2]
Poon C. M., Ng Dennis C. K., Cheung M. H. Y., Li R. S. K., Leong H. T. Recurrence Pattern of Fistula-in-Ano in a Chinese Population. J Gastrointestin Liver Dis. 2008; 17(1): 53-57.
[3]
Ramanujam P. S., Prasad M. L., Abcarian H. The role of seton in fistulotomy of the anus. Surg Gynecol Obstet. Nov 1983; 157(5): 419-22.
[4]
Sainio P. Fistula-in-ano in a defined population. Incidence and epidemiological aspects. Ann Chir Gynaecol. 1984; 73(4): 219-24.
[5]
Sun M. R., Smith M. P., Kane R. A. Current techniques in imaging of fistula in ano: Three-dimensional endoanal ultrasound and magnetic resonance imaging. Semin Ultrasound CT MR. Dec 2008; 29(6): 454-71.
[6]
Parks A. G., Gordon P. H., Hardcastle J. D. A classification of fistula-in-ano. Br J Surg. Jan 1976; 63(1): 1-12.
[7]
Koutroubakis I. E. The patient with persistent perianal fistulae. Best Practice & Research Clinical Gastroenterology 2007; 21(3): 503–518.
[8]
John M., John A. S., N. Simon A. MR Imaging Classification of Perianal Fistulas and Its Implications for Patient Management. RadioGraphics 2000; 20: 623–635.
[9]
Halligan S., Stoker J. Imaging of Fistula in Ano. Radiology 2006; 239(1): 18-33.
[10]
Pierpaolo S., Federica C., Stefano D. U., Luana F., Giovanna D. V. B., Elisabetta D. L., et al. Surgery for fistula-in-ano in a specialist colorectal unit: a critical appraisal. BMC Gastroenterology 2011; 11: 120.
[11]
Krisztina B. G., Willem B., Michael A. K., Jaap S., Reena K., Siew C. N., et al. A global consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn’s disease. Gut 2014; 63: 1381–1392.
[12]
Jaime de M. C., Laura G. del. S., Patricia F. R., Luis F. A. del. H., Leticia G. V., M. Isabel D. P. de. V., et al. MR Imaging Evaluation of Perianal Fistulas: Spectrum of Imaging Features. Radio Graphics. 2012; 32: 175–194.
[13]
Wu C. L. Experience on the treatment of acute anorectal abscess with primary fistulotomy. Gaoxiong Yi. Xue. Ke. Xue. Za. Zhi. 1990; 6(5): 218-23.
[14]
Lunniss P. J., Jenkins P. J., Besser G. M., Rerry L. A., Phillips R. K. Gender differences in incidence of idiopathic fistula-in-ano are not explained by circulating sex hormones. Int J Colorect Dis 1995; 10: 25-8.
[15]
Malouf A. J., Cadogan M. D., Bartolo D. C. C. Anal canal. In Surgery Edited by: Corson JD and Williamson RCN. London: Mosby; 2001: 3.21.1-26.
[16]
Murtaza A. Fistula in Ano - An Overview. JIMSA. 2012; 25(1): 53-55.
[17]
Mark H. W. Perianal Abscess/Fistula Disease. Clin Colon Rectal Surg 2007; 20:102–109.
[18]
Malouf A. J., Buchanan G. N., Carapeti E. A., Rao S., Guy R. J, Westcott E., et al. A prospective audit of fistula-in-ano at St. Mark's hospital. Blackwell Science Ltd. Colorectal Disease 2002; 4: 13-19.
[19]
Vasilevsky C. A., Gordon P. H. Results of treatment of fistula in ano. Dis Colon Rectum 1984; 28: 225-31.
[20]
Marks C. G., Ritchie J. K. Anal fistula St. Mark's Hospital. Br J Surg 1977; 64: 84-91.
Open Science Scholarly Journals
Open Science is a peer-reviewed platform, the journals of which cover a wide range of academic disciplines and serve the world's research and scholarly communities. Upon acceptance, Open Science Journals will be immediately and permanently free for everyone to read and download.
CONTACT US
Office Address:
228 Park Ave., S#45956, New York, NY 10003
Phone: +(001)(347)535 0661
E-mail:
LET'S GET IN TOUCH
Name
E-mail
Subject
Message
SEND MASSAGE
Copyright © 2013-, Open Science Publishers - All Rights Reserved