Introduction. Perianal fistula is usually of cryptoglandular origin, namely
it results from inflammation of the anal glands. The main challenge in its
management is how to resolve a fistula but avoid its recurrence as well as
incontinence, which is even a bigger problem. Several treatment methods have
been described and they all focus on cutting the anal sphincter and ?opening?
the fistula, placing the seton, plug technique, creating a mucosal
advancement flap, injecting medical occlusive agents or using a combination
of methods. In 2007 a method of managing a fistula by ligation of the
intersphincteric fistula tract was described. The procedure is still getting
a wider application. Case Report. A 60-year old male patient had had a
fistula for 30 years. He underwent incision of perianal abscess on multiple
occasions resulting in multiple scars in the gluteus area. The diagnosis
revealed a high transsphincteric fistula. The inner ostium was diagnosed by
injecting hydrogen-peroxide and by probing. The patient?s general condition
was satisfactory. For the first time the ligation of intersphincteric fistula
tract procedure was applied in our regional hospital. Under general
anesthesia, in a lithotomy position, the ligation of intersphincteric fistula
tract procedure was successfully performed in approximately 30 minutes. The
external opening of the fistula and the scars were widely excised. The
postoperative course was uneventful. After 6 months there was no recurrence.
Conclusion. The ligation of intersphincteric fistula tract procedure for
transsphincteric fistulae can be a treatment of choice in all hospitals
treating colorectal patients because the incontinence risk is low and the
disease is curable at a high percentage.
Case Report of Schistosomiasis Complicated with Perianal Fistula
