Anal fistula

Anal fistula outlined short anal fistula, anal canal and rectum perianal skin infection linked to the pipeline, I located within its tooth line near the mouth outside in the skin around the anus, the perennial holdback. Cause pathogenesis most anal fistula by anorectal abscess rupture or incision and drainage must be made after the formation. Abscess gradually narrowed, but still intestinal contents continuous access vomica, the shrinking of the healing process, often tortuous cavity formation, poor drainage healing is not easy, after falling cavity Road around many scars, chronic infections pipeline. Walking in the vicinity of internal and external sphincter, external skin faster growth, more often false, caused repeated attack. Pipeline Most of the infected purulent infection, a small number of tuberculosis. According to the fistula fistula and the location, depth, height and number of their classification : (1) fistula and AV fistulas and outside at least two fistula, one of the perianal skin. the majority from the anus two-three centimeters, called the mouth, the other in the intestinal lumen, mostly in the tooth line of anal sinus called within the mouth, within a few teeth in the mouth-line side, rectal wall. Fistula within the mouth with the same external fistula, no wounds, clinical findings 90% of fistulas. (2) low leakage and high fistula fistula at the anorectal ring plane below for low leakage, the plane over to the high fistula. The latter approach to the treatment of the choice. (Figure 2-104). Figure 2 -104 types of anal fistula (3) simple and complex anal fistula anal fistula former only a fistula, The latter could range fistula and fistula. From a clinical point of anal sphincter fistula and the relationship more important, can be divided into : sphincter between the type -- the most common one. at the mouth within the tooth line, fistula between the internal and external sphincter walk outside mouth in the skin around the anus; After sphincter-type -- fistula Foreign anal sphincter and ischium gap in the skin around the anus and passed through; ۠sphincter-on -- not uncommon. Fistula Ibid break levator ani muscle in the perianal skin piercing distant; sphincter appearance -- rare, with a population of tooth Buy rectum and anal orifice in distant skin, in internal and external sphincter fistula, by the levator ani muscle down (Figure 2 -105). Figure 2 -105 anal fistula anatomy of the four types of clinical manifestations discharging main symptoms, and the number of fistula Pott length The number, the new fistula discharging more to stimulate the secretion of the skin itching and discomfort when the foreign or pseudo - obstruction of healing, Cumulative fistula within Pott, local swelling pain, or even fever, after the fistula was closed rupture, the general tenor of the symptoms disappear. Due to poor drainage, recurrent abscess, but also there are a number of ulceration outside mouth. More high-rectal fistula, often feces or gas emitted from the outside population. I check outside of a regular papillae or granulation tissue swelling, squeeze a small amount of purulent discharge, mostly for a single orifice, in the vicinity of the anus. Also a number of foreign export, foreign export fistula between subcutaneous transmitters, hardware and skin atrophy. There are a number of external aperture located on both sides, fistula as a "horseshoe-shaped" digital rectal examination in the lesion can be touched sclerosis or blood clot. a tender, with the cable proximal exploration, sometimes palpable within the mouth. If outside mouth disordered, not uplift, prowling the edge of granulation or gray and white cheese - like thin secretions. suspected to be tuberculosis anal fistulas. Anal fistula diagnosed with mouth is a primary lesion site, a clear positioning will inevitably lead to treatment failure. removed or cut because I was cured within Anal Fistula the key. Find and set within the anal fistula mouth method are : (1) rectal endoscopy under direct vision to see all the tooth line, I often within the redness of inflammation anal fistula, secretions, anus of suspicious silver garden crypt available first probe into exploration. (2) first inspection probe inserted in the anus fingers, silver Park with the first probe, from the outside to the pipeline joints gently explore mesocaval direction, it is fully anal fistula, mesocaval fingers within the tooth line near the apartment probe to ascertain mouth, the explorer when avoid blindly, hardworking, tax into a false passage, so that the spread of the infection. (3) staining of dry gauze Add rectum, a ~ 2 ml methylene blue from the outside I was slowly injected. then pull out the gauze, if staining proved that there exists within the mouth. (4) surgical incision leakage inspection, along with fistula I find generally easy to find. Treatment (1) acute infectious attack, the application of antimicrobial agents, local physiotherapy, bath with hot water, abscess formation should incision. (2) apply for fistula incision simple low anal fistula, internal and external sphincter between the fistula. Open fistula injury only part sphincter, sphincter subcutaneous and shallow, we will be after fecal incontinence. General anesthesia in the saddle, with a probe inserted from the outside population, the scope of the fistula with piercing mouth, the direction of incision along the probe fistula, granulation tissue decay will climb scratch clean, in order to guarantee the fistula outward from the bottom of the growth can be on both sides of the skin incision cut a little, I was the small end of a "V" - shaped wound, while paying attention to any branch pipeline, we should all open one. Figure 2 -106 hung anal fistula (3) link line therapy apply simple high anal fistula, that is, within a population of anorectal ring plane above, surgical cut can cause fecal incontinence. Using fistula and to enable Nazarbayev broken sphincter and surrounding tissue adhesion first produced by ligation after ischemia, necrosis, After 10 ~ 14 days after their own fault, this time not shrink incontinence, fistula into an open wound, to gradually healing. Methods : probe from the outside by mouth, I passed through fistula, a sterile probe guide thick silk or rubber-band, this line from the inside and export fistula mouth and outer leads (Figure 2 -106), and then tightly enclosed silk thread. Line to be linked to : within I find the exact location not cause false passage, the failure-free operation; tighten the string or elastic ago, Open to the skin and subcutaneous sphincter, in order to reduce postoperative pain, shorter off-line date; ۠ligation due to tighten, Guo Song difficult Prat broken fistula. After bath with hot water, 3 ~ 5 days once again taut, generally two weeks will complete fracture. (4) Fistulectomy apply simple low anal fistula, and the incision is different from fistula and will be separate and surrounding tissue removed until exposed health organizations outside the small wound, generally not repaired, after Lotion, medication, until healed. High or complex anal fistula surgery to preserving the anal canal and rectum, the avoidance of postoperative fecal incontinence.