Anal abscess and fistula (abscessus ani et Fistula ani)
Anal abscess and anal fistula are two completely different clinical conditions of the same disease.
Anal abscess is an acute condition characterized by a swelling near the anus, strong pain and often increased temperature.
Ninety percent of abscesses are the result of an acute infection in the internal glands of the anus.
This infection develops rapidly and within two or three days the process is spread to the skin surrounding the anus which becomes red,swollen and painful.That is when a patient asks for doctor’s help.
An anal fistula (Fistula ani) is a chronic condition which occurs in 99% of cases after an anal abscess.
Currently there is no medical treatment available for this problem and surgery is almost always necessary to cure an anal fistula. if the fistula is straightforward (involving minimal sphncter muscle), a fistulotomy may be performed.
This procedure involves unroofing the tract, thus connecting the internal opening within the anal canal to the external opening and creating the groove that will heal from the inside out.
Anorectal dull pain, drainage from the perianal skin,irritation of the perianal skin and sometimes rectal bleeding, can be presenting symptoms of a fistula ani.
This is a chronic condition which means that patients can have troubles for years before they decide to undergo the operation which is the only way of treatment.
Treatment of anal abscess
The treatment of an abscess is surgical drainage under most circumstances.
An incision is made in the skin near the anus to drain the infection.
It is done with local anaesthetic.
Immediately after this intervention the patient is relieved of pains and his general condition is improving and the temperature comes back to normal.
With the help of antibiotics the treatment is relatively short and the patient can soon get back to his daily activities.
Treatment of anal fistula
Different methods have been used in treatment of anal fistula.
However, a famous English proctologist, professor Parks has introduced a new method which is used in emminent proctolgy centres as well as in the Atlas general hospital.
It is a very simple revolutionary method and gives excellent results.
In most conventional operations anal fistula is excised together with external fistula opening.
It is usually followed by a high percentage of recurrences because the internal opening always remains and a new fistula is formed.
Operation (fistulotomy) introduced by professor Parks successfully solves the problem of anal fistula.
The aim is to identify the internal opening.When it is identified by using a special probe , then the procedure is very simple because the bridge between the external and internal fistulous opening is severed, thus permanently preventing the formation of new fistula.
This procedure is safe when performed by an experienced surgeon and it is carried out in doctor’s office under local anaesthesia.
After the operation, the patient does not have any problems and feels no pain.It is necessary for the patient to have regular baths for two weeks.
The patient can leave the hospital the same day and he can immediately get back to his daily activities.
Dr Dr Milošević MladenSpecialist in general surgery