Fistula and Abscess

Colorectal Diseases

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Prof. Dr. Gokhan CIPE

What is Anal Fistula and Abscess?

Anal abscess is a cavity filled with inflammation near the anus or rectum.

The perianal fistula are small tunnels between the previously inflamed anal glands and the skin outside the anus. Perianal fistulas almost always result from previous abscesses. There are small glands in the entrance of the anus. Abscess occurs when the ducts of these glands become clogged.

What are the symptoms of abscess or fistula?

The abscess usually presents with pain and swelling around the anus. In addition, some people may experience weakness, fever and chills. Symptoms associated with the fistula include wetness and discharge of inflammation around the anus.

Does Abscess Always Become a Fistula?

No. Fistula occurs in 50% of patients with evacuated abscess and there is no way to predict which patients will develop a fistula.

How is abscess treated?

The abscess is treated by opening the skin near the anus and evacuating the inflammation. Sometimes this procedure can be performed in the outpatient clinic with local anesthesia, while general and anesthesia and hospitalization may be required in large and deeply located ones.

How is the fistula treated?

Surgery is necessary for the treatment of perianal fistula. Fistula operations are usually based on cutting and opening of fistula tunnels. Sometimes it may be necessary to cut some of the anal sphincter muscles that hold the stool when this tunnel is opened. In deeply located and complicated fistulas, different surgical options such as seton application, advancement flaps and LIFT method can be applied. Suitable patients can be treated with laser. The surgical method is determined according to the patient.

How Long Does It Take for Patients to Recover After Treatment?

Moderate pain that may occur for 1 week after fistula surgery can be controlled with medications. Hot water sit baths are recommended 3-4 times a day. Stool softeners are recommended. It may be necessary to use gauze or pads to prevent underwear from getting dirty. Defecation has no negative effect on wound healing.

What is the probability of abscess or fistula recurrence?

If wound healing is completed without problems, it usually does not recur. However, following the recommendations of the operating surgeon and following the controls regularly will help prevent the recurrence of the disease.

Robotic Surgery

General Surgery