PERIANAL FISTULAE: CLINICAL EXPERIENCE IN TERTIARY HEALTH CARE HOSPITAL
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Keywords
Perianal fistulae, clinical presentation, fistulotomy, fistulectomy
Abstract
Introduction: Perianal fistulae are the granulation tract between anus or rectum and overlying skin with incidence of 9/100,000. It mostly affects the males with male to female ratio of 1.8:1. Mean age of presentation is 41.6+/- 11.4 years. Causes of perianal fistulae mainly divided in to cryptoglandular and non cryptoglandular causes. The basic pathophysiology of perianal fistulae formation was explained by cryptoglandular hypothesis. Park classification is commonly used to stratify perianal fistulae. Its diagnosis is mainly clinical but MRI and endoanal ultrasound aids in diagnosis and formulation of treatment logarithm. Multiple treatment options are available for the management of perianal fistulae but results are disappointing because it has high reoccurrence rate. Aim of this study was to assess the clinical presentation and treatment given to patient.
Material And Method: Cross-sectional, observational retrospective study was conducted on 75 patients in general surgery and surgical oncology unit 2 of Sheikh Zayed Hospital in Lahore. The study lasted from January 27, 2022 to April 27, 2023. The non- probability, convenience sampling technique was used. Inclusion criteria include all patients with perianal symptoms and external perianal opening. Exclusion criteria include perianal fistulae due to secondary causes and recurrent perianal fistulae.
Results: In this study most of the patients were male (89.33%). With male to female ratio of 8.37:1. Mean age of presentation was 42.33+/- 12 years. Most common presentation of peri-anal fistulae was perianal discharge (75%) followed by peri-anal pain (60%). Most of the openings were located on posterior side (77%). Most common procedure done was fistulotomy (67%) followed by setone placement (20%). About 76% of the patients had single per-anal external opening.
Conclusion: Fistulae in ano is the most common pathology of the lower GI tract. That has a devastating impact on patient’s mental and social health. But early diagnosis and prompt treatment help reduce its complications.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Daniyal Javed
Trainee Registrar, Sheikh Zayed Hospital, Lahore Pakistan
M Imran Anwar
Professor and Head of Department, General Surgery and Surgical Oncology Department, Sheikh Zayed Hospital, Lahore Pakistan
Muhammad Hamza Laique
Trainee Registrar, Sheikh Zayed Hospital, Lahore Pakistan
Muhammad Rizwan
Trainee Registrar, Sheikh Zayed Hospital, Lahore Pakistan
Muhammad Zain ul Abid
Trainee Registrar, Sheikh Zayed Hospital, Lahore Pakistan
Muhammad Ali Askari
Trainee Registrar, Sheikh Zayed Hospital, Lahore Pakistan