Advancement Flap and Ligation of Intersphincteric Fistula Tract
4 results
1 - 4
Anorectal Disease- A 43-year-old man presents with perianal fistula. Examination revealed an internal opening to be at the dentate line. Magnetic resonance imaging revealed a transsphincteric fistula encompassing half of the external sphincter with the mucosal opening at the right anterior location. No abscess or collections are present. What is the most appropriate surgical management for this patient?
- A 40-year-old woman, gravida 2, para 2 (both vaginal deliveries), initially presents with a transsphincteric anal fistula. She undergoes a ligation of intersphincteric fistula tract (LIFT) procedure. The patient now reports persistent seropurulent drainage from the surgical incision approximately 4 weeks postoperatively. Magnetic resonance imaging of the pelvis reveals an intersphincteric fistula but no associated abscess. Of the following options, which is the best next step in management of this patient’s fistula?
- A 53-year-old woman, gravida 3, para 3, with a BMI of 38 and diabetes, and who is an active smoker presents to your office with a draining seton placed for recurrent fistula in ano. Magnetic resonance imaging (MRI) shows a right anterolateral transsphincteric fistula with an anterior sphincter defect. Which factor places her at the highest risk for anal advancement flap failure?
- Benign Disease