TROPIS : NOT ALL COMPLEX FISTULAE IN ANO NEED COMPLEX MANAGEMENT - A CASE REPORT

Dr. Saket Goel; Dr. Kalpit Goriwal; Dr. Avinash Kaul; Dr. Adheesh Goriwal

Volume : IX, Issue : II, February - 2019

TROPIS : NOT ALL COMPLEX FISTULAE IN ANO NEED COMPLEX MANAGEMENT - A CASE REPORT

Dr. Saket Goel, Dr. Kalpit Goriwal, Dr. Avinash Kaul, Dr. Adheesh Goriwal

Abstract :

INTRODUCTION: High and complex fistula in ano frequently present with collection in the intersphicteric plane. This type of fistula have a management difficulty due to their proximity to the anal sphinter and risk of developing iatrogenic incontinence. TROPIS (Transanal opening of intersphinteric space) is a new and innovative method of managing such fistulae/ perianal collections without risk of incontinence. PRESENTATION OF A CASE: A 66 year old gentleman presented with the chief complaints of perianal pain and fever. He did not have any external component in form of swelling or opening. MR Fistulogram demonstrated a horse shoe shaped collection in the inter sphincteric space extending from 3 to 9 o’clock position with no external component. Internal Drainage of collection was performed as operative management (TROPIS). DISCUSSION: We managed our patient with TROPIS and found that the road to recovery was smooth, as compared to conventional line of management for such cases. CONCLUSION: We advocate the use of TROPIS for complex, high fistula in ano with intersphincteric collection.