Volume : IX, Issue : V, May - 2020

FISTULA IN ANO : A PROSPECTIVE CLINICO-PATHOLOGICAL STUDY

Rajyajyoti Malakar, Vipin Kumar

Abstract :

BACKGROUND: To describe the incidence of various etiologies and to study the modes of clinical presentation including pathological characteristics of fistula in ano. METHODS: This cross–sectional study entitled “Fistula in ano : A prospective clinico–pathological study” was conducted at The Department of General Surgery, Teerthanker Mahaveer Medical College & Research Centre during the study period November 2017 – November 2019 on patients who attended the surgery out–patient department and were diagnosed with fistula–in–ano and who underwent relevant surgical procedure. RESULTS: In present study of 50 cases, 56% of cases were in the age group of 20–40 years. Male:female ratio was 8:2. 68.0% of population were of low socio–economic status. Perianal irritation was found among 28.0%, Pain among 4.0%, Swelling among 70.0%, Discharge among 96.0% and Perianal abscess among 24.0% of subjects respectively. Past history of TB was found among 2 (4.0%) patients. There was one external opening among 76.0%, two among 18.0% and more than 2 among 6.0% of patients. Fistula was found to be anterior among 30.0% cases and posterior among 70.0% of patients. Level of fistula was found to be High among 10.0% and Low among 90.0% patients. Associated Fissure was found among 8.0% and Haemorrhoid among 4.0% patients. Probing of Tract showed that 35 (70.0%) had Curved tract and 15 (30.0%) had straight tract. The most common surgical approach done was fistulectomy. Only Fistulectomy was done for 40 patients (80.0%). Fistulotomy was done for 6 patients (12.0%). And fistulectomy with fissurectomy with lateral anal sphincterotomy was done for 4 patients (8.0%) as these 4 patients had associated anal fissure. Complete healing period range from 2 weeks to 8 weeks. Maximum patients (72%) got healed in 3–6 weeks. Excised fistula tract on biopsy (HPE) showed no specific aetiology in 48 patients whereas in 2 patients it revealed specific tubercular aetiology. All the cases underwent definitive surgery. It was found that fistulectomy was superior treatment option compared to fistulotomy as there is evidence of complete healing with no recurrence following surgery. In our study, post–operative period were uneventful with minimal CONCLUSION: Fistula in ano is common between 20 – 50 years with male predominance. Low socioeconomic status is one of the risk factor may be due to illiteracy and poor hygiene. Previously, burst abscess or inadequately drained perianal abscess is the main aetiological factor found. Low type and posterior type of perianal fistula is common with discharging sinus as a commonest mode of presentation. Fistulectomy is the commonest suitable procedure for low type of fistula with less postoperative complication.

Keywords :

Article: Download PDF    DOI : 10.36106/ijsr  

Cite This Article:

FISTULA IN ANO : A PROSPECTIVE CLINICO-PATHOLOGICAL STUDY, Rajyajyoti Malakar, Vipin Kumar INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-9 | Issue-5 | May-2020

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