Anal abscesses are a relatively common condition and most often occur as the result of infection of an anal gland. Perianal abscess is an emergency and should always be drained in a timely fashion. Delayed or inadequate treatment may occasionally cause extensive or life-threatening tissue necrosis and septicemia. Anal fistula is an abnormal connection between the anal canal and the skin around the anus. Anal fistula can be classified depending on where the fistula runs in relation to the anal sphincter muscles.
Symptoms of anal abscess and fistula
Anal abscess or fistula usually present with symptoms of pain or drainage of pus. Occasionally anal fistula may be related to Crohn’s disease or, very uncommonly, anorectal cancer.
Diagnosis of anal fistula
Physical examination may reveal the external opening of the anal fistula. It is critical to establish the course of the fistula tract prior to therapy. The goal of surgery is to eliminate the sepsis whilst maintaining continence. Sometimes, magnetic resonance imaging (MRI) will be useful in accurately mapping the extent and severity of the fistula.
Treatment of anal fistula
Simple intersphincteric fistulas can be treated by a lay open or fistulotomy procedure (surgical opening of the fistula tract). Fistulas that involve a significant number of the sphincter muscles are more safely treated by initial placement of a seton. A seton is a fine thread [usually of thin, coloured rubber]