Recurrent Multiple Complex Anal Fan-Shape Fistula
Journal Title: Journal of Clinical & Medical Case Reports - Year 2016, Vol 3, Issue 1
Abstract
Introduction: Fortunately, recurrent multiple complex anal fistula is an uncommon pathology; however, it is at times frankly impossible to cure and entails considerable fear regarding application of thetherapeutic option. Surgical techniques are varied, failure can have fatal consequences, and experience is minimal. Objective: Report the case of a patient with diagnosis of recurrent multiple complex anal fistula and his surgical treatment by classic fistulectomy and anal sphincter reconstruction. Methods: Male patient, age 42 years, without significant history for the present condition, with presence of a single anal fistula of 12 years’evolution. First surgery with fistulotomy 3 years prior. Suffering relapse,with clinical classification of complex, patient was reoperated one year later, applying a seton on a single fistulous tract, reporting 2 additional tracts and biweekly adjustment for seven months without improvement.Patient was evaluated by our service, finding 5 secondary orifices with tracts of up to 12 cm from the edge of the anus, with a single primary tract in the 6 o’clock sector at the level of the toothed line. Patient was subjected to surgical protocol, performing fistulectomy with complete section and plasty of the anal sphincter complex. Patient was diagnosed with recurrent transsphincteric complex “fan-shape” fistula with five fistulous processes, with satisfactory postoperative evolution, presenting complete healing and without sequelae. Conclusions: Fistulectomy, although presently proscribed, is resolutive; it is believed to entail a high risk of incontinence, which can be avoided with precise anatomical knowledge and proper application of surgical technique.
Authors and Affiliations
Morelos Adolfo Garcia Sanchez
Keywords
Related Articles
- EP ID EP207618
- DOI 10.13188/2332-4120.1000016
- Views 135
- Downloads 0
Prophylactic Donor Lymphocyte Infusion to Prevent Relapse after Allogeneic Stem Cell Transplantation
Donor lymphocyte infusion (DLI) has been used to treat disease relapse after stem cell transplantation, but high incidence of graftversus- host disease (GVHD) after traditional DLI, and low response rates with robust rel...
Congestive Heart Failure Treated with a Multiple Micronutrient Supplement Program: A Case Report
Congestive heart failure is a chronic progressive disorder of the cardiovascular system with loss of function of the cardiac myocytes. There is no cure and treatments only attempt to reduce the severity of symptoms. We p...
Asymptomatic Presentation of Mediastinal Actinomycosis in a Pediatric Patient with AcuteLymphoblastic Leukemia: Case Report and Discussion
We report a nine year old male with Philadelphia positive Precursor B Acute Lymphoblastic Leukemia who was diagnosed with mediastinal actinomycosis following failed central line placement. The patient had a normal chest...
Giant Intraductal Papilloma: A Rare Case
Intraductal papilloma is a benign fibroepithelial tumor of the breast. It constitutes approximately 5% of all breast cancers. Although it can be seen at any age, it is mostly seen in late reproductive age and during peri...
Reye’s like Syndrome in an Adult; a Forgotten Entity
We report a case of 25 years old Caucasian lady who was admitted with history of use of non-steroidal anti-inflammatory drug for a viral like illness, repeated vomiting and hypokalemia. Her endoscopy showed pyloric steno...