Why Unnecessary Wide Excision in Fistula in ano?

4,882 views

Published on

Fistula is caused by cryptoglandular infection. In order to completely heal the fistula, it is wise to eradicate the cryptoglandular infection.
Unnecessary excision of perianal tissue ought to be avoided. It causes stricture, incontinence and several other problems.

Published in: Health & Medicine, Business
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
4,882
On SlideShare
0
From Embeds
0
Number of Embeds
8
Actions
Shares
0
Downloads
37
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Why Unnecessary Wide Excision in Fistula in ano?

  1. 1. Why Unnecessary Wide Excision?
  2. 2. Peri-anal Fat is precious, Anal Musculature is complex and indispensible, So Why unnecessary and over enthusiastic excision of precious tissue?
  3. 3. Previous surgery with seton in situ – large isheorectal abcess right side Case 1
  4. 4. Laying open of tract with seton placement
  5. 5. Incision and drainage of abscess – cavity communicating with internal opening
  6. 6. Probing Case 2 External opening
  7. 7. Methylene Blue injection – no external opening
  8. 8. Coring
  9. 9. Excision of tract till blind end – bone palpable
  10. 10. Packing of wound
  11. 11. Case 3 Multiple external openings - Probing
  12. 12. Laying open tract
  13. 13. Anterior horse shoe type fistula – lay open – internal opening at 6 o clock.
  14. 14. Seton placement – partial sututing of open wound
  15. 15. Case 4
  16. 16. Coring of two external openings
  17. 17. Opening made at 6 o clock position with seton placement
  18. 18. Case 5
  19. 19. MRI gluteal region  Complex grade V intersphintric translevator perianal fistula with two external openings on right side and opening in translevator area on right side after crossing midline
  20. 20. Probing Joining two external openings
  21. 21. Internal opening at 6 o clock Lay open tract – seton placement
  22. 22. Is it avoidable?  Yes  I shall come up with solutions in next presentation.

×