Cryptoglandular Abscess and Fistula
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Cryptoglandular Abscess and Fistula- Key Concepts
- Recommendation
- References
- Introduction
- Cryptoglandular Pathophysiology
- Diagnosis
- Treatment
- Acute Fistula Management
- Post-drainage Care
- Post-drainage Antibiotics
- Anal Fistula
- Presentation/Symptoms
- Classification
- Preoperative Imaging for Fistula Characterization
- Treatment Strategies
- Intraoperative Fistula Identification
- Fistulotomy
- Setons
- Draining Seton
- Cutting Seton
- Loose Seton as Definitive Treatment and External Anal Sphincter-Sparing Seton
- Fibrin Glue
- Fistula Plug
- Endorectal Advancement Flap (ERAF)
- Ligation of Intersphincteric Fistula Tract (LIFT)
- Novel Surgical Therapies
- Rectovaginal Fistula
Complex Anterior Anorectal Fistulae in Women
Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula (2022)
Anorectal Disease
Benign Disease- A 30-year-old woman with a history of perianal Crohn’s disease has had a seton in place for transsphincteric fistula for the past 2 months. She is also taking infliximab for medical management of her Crohn’s disease with no active proctitis seen on recent endoscopy. Ultrasonography shows 50% involvement of the sphincter complex with no undrained abscess or high blind tracts. What is the most appropriate management approach for her fistula?
- An 85-year-old man presents to your office with complaints of intermittent rectal bleeding. His history is notable for prostate cancer treated with external beam radiation. Sigmoidoscopy reveals mucosal pallor, superficial ulceration, and telangiectasias in the distal rectum, and a biopsy specimen is obtained from the anterior rectal wall. Two weeks later, the patient develops pelvic pain, fever, and a watery rectal discharge that occurs while voiding. This presentation is most concerning for:
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