PERIANAL ABSCESSES

PERIANAL ABSCESSES - PERIANAL FISTULAS

• Perianal abscesses; It starts from the anal canal lined with crytoglandular epithelium,

• The internal anal sphincter normally functions as a barrier, but where there are crypts, this barrier integrity is disrupted,

• Once the infection reaches the intersphincteric area, it can spread from there to neighboring areas,

• Infection of the soft tissues around the anal canal/abscess development occurs,

• It is most common between the ages of 30-40,

• It is more common in men than women,

• % of patients 30 of them had a history of a previous abscess that healed on its own or with surgical intervention.

• Abscesses; It recurs at a rate of 10-15%, fistula develops in 15-40% of abscesses,

• It is more common in summer and spring,

• There is no connection between personal hygiene, diarrhea or bowel habits and the frequency of occurrence.

FACTORS PREPARED FOR THE FORMATION OF PERIANAL ABSCESS:

• Foreign body,

• Trauma in the anal area,

• Previous surgeries,

• Malignancy,

• Hidradenitis suppurativa,

• Immunodeficiency

• Diabetes, tuberculosis, obesity

• Radiation,

• Crohn's disease,

WHAT KIND OF COMPLAINTS DOES PERIANAL ABSCESS CAUSE?

• In the perianal region feeling of discomfort,

• Pain (increasing with movement, defecation, sitting),

• Itching feeling in the perianal area,

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• Fever, weakness, chills,

• Discharge that increases and decreases from time to time when fistula develops.

HOW TO DIAGNOSE PERIANAL ABSCESS:

• Examination

• In doubtful cases; imaging methods (MR, Tomography, Ultrasonography)

HOW IS PERIANAL ABSCESS TREATED?

• Draining the abscess is the most basic treatment method,

• The use of antibiotics is recommended. There are those who do not recommend it. There are those who recommend its use in patients with a risk of severe infection (such as diabetes, immune suppression, valve disease). It would be most appropriate to choose antibiotics according to the patient and the surgeon's preference.

• Should fistula surgery be performed along with abscess drainage?! There is controversy. In general, fistula treatment is planned for later.

WHAT ARE THE TREATMENT OPTIONS IN PERIANAL FISTULAS?

• fistulotomy / fistulectomy

• Seton

• Glue treatment

• Anal flaps

• LIFT(ligation intersphincteric fistula tract)

• Closing the fistula line with laser

When making a treatment plan for perianal fistulas, the patient should be spoken to carefully, the risks, the possibility of recurrence of the disease/success rate should be explained in the best possible way.

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