SIGNIFICANCE OF THE FISTULOGRAPHY FOR OPERATIVE TREATMENT OF THE FISTULA-IN-ANO

N. Moljević ,
N. Moljević

Clinical Center Novi Sad, Institute for Surgery, Clinic for abdominal and endocryne surgery , Novi Sad , Serbia

M. Vuković ,
M. Vuković

Clinical Center Novi Sad, Institute for Surgery, Clinic for abdominal and endocryne surgery , Novi Sad , Serbia

R. Veljković
R. Veljković

Clinical Center Novi Sad, Institute for Surgery, Clinic for abdominal and endocryne surgery , Novi Sad , Serbia

Published: 01.01.2005.

Volume 33, Issue 1 (2005)

pp. 19-24;

https://doi.org/10.70949/pramed200501106M

Abstract

Most fistula-in-ano arise as result of chronic infection of an intersphincteric anal glands and persistence may be related more to non-specific epitelisation of the track. Preoperative definition of the anatomy of the fistulous track and the internal opening plays a primary role in adequate planing of the operative approach to minimize iatrogenic damage of sphincters and fistula recurrence. The diagnosis of anal fistula generally is straightforward and is based on clinical features. By
using palpation of the perianal area, digital examination, and careful probing of the track, the fistula anatomy was defined.
Fistulography, radiografic evaluation, is not routinely indicated in the initial avaluation of fistulas but may be helpful in identyng an occult cause of recurrent or multiple fistulas or if examination is suggestive of inflammatory bowel disease. AIM:
is evaluation of importance of the fistulography for surgical treatment of the fistula-in-ano. The study is prospective. In includes 60 patients divided in two groupies, each 30 patients. Examined group was operated after clinical findings by using
careful probing of the track and fistulography. Control group was operated after clinical findings by using careful probing of the track. In patients, examined group, treated with fistulography allowed a corect diagnosis of primary track 43.3%, secondary track 40.0%, horseshoe track 50.0% and internal opening in 40.0% of patients. The clinical findings, in the same group patients, allowed diagnosis of primary track 76.6%, secondary track 60.0%, horseshoe track 100% and internal opening in 73.3% of patients. Preoperative definition of fistulous track and internal opening by physical examination and its relationship with anal sphincters are important factors influencing the results of surgical management. We do not recommend routine fistulography in the diagnosis of fistula-in-ano. 

Keywords

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