Anal fistula and anal sepsis are the part of spectrum of anorectal suppurative diseases. The abscess represents the acute inflammatory event, whereas the fistula is representative of the chronic process. A perianal abscess (also known as anorectal abscess or anal sepsis) is an infection of the soft tissues surrounding the anal canal with formation of a discrete abscess cavity. A fistula-in-ano is a hollow tract lined with granulation tissue connecting a primary opening inside the anal canal to a secondary opening in the perianal skin through which an abscess has been drained or has spontaneously ruptured. In some fistulas, there may be only an internal opening leading to a blind tract. Symptoms generally affect quality of life significantly and range from minor discomfort and drainage with resultant hygienic problems to distressing sepsis. Treating an abscess is relatively straightforward. However, eradicating anorectal fistulas is challenging and often frustrating for both the surgeon and the patient. The lack of any standard surgical procedure and heterogeneity of anorectal fistula warrants the surgeon to use his “judgment” more than in most colorectal diseases.
KeywordsAnal Fistula Internal Opening Internal Sphincter Advancement Flap Fistulous Tract
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