scholarly journals A Novel Technique of Branchial Fistula Tract Delineation and Excision In Children Allergic To Dyes

2015 ◽  
Vol 23 (2) ◽  
pp. 43-47
Author(s):  
Swagatam Banerjee ◽  
Saurav Sarkar ◽  
Sanjoy Ghosh ◽  
Sharmistha Chakravarty ◽  
Biswajit Sikder
Keyword(s):  
Fistulous Tract ◽  
Sinus Tract ◽  
Medical Advice ◽  
Fistula Tract ◽  
Blue Colour ◽  
Novel Technique ◽  
Adjacent Structures ◽  
Gentle Traction ◽  
Branchial Fistula ◽  
Operative Recovery

IntroductionBranchial arch fistula which results from a second arch anomaly is rarely seen in practice. The patients usually seek medical advice for persistent discharge from an opening in the neck or mucopurulent discharge from the opening of an infected fistulous tract. The treatment of choice for such a fistula is excision. Materials and MethodsA total of seven patients were operated for branchial fistula between 2010 and 2012. Among them, three children could not undergo a fistulogram due to allergy to the dye used and hence they were selected for our modified procedure. Surgical ProcedureA 3-0 or 4-0 polypropylene (Prolene™) thread was inserted into the fistulous tract. Both the ends of the tract were secured with the thread and the sinus tract was dissected out under gentle traction. ResultsThe patients who were allergic to dye could not have preoperative fistulograms and per-operative injection of dye was also avoided. The blue colour of the polypropylene thread inserted in the fistula tract helped in tracing and excision of the sinus tract. No major complications occurred during or after fistulectomy and the post-operative recovery was uneventful. No recurrence was seen in the scheduled follow-ups. ConclusionSurgical excision of branchial fistulas in children with allergy to dyes can be challenging. Insertion of a polypropylene thread into the fistula tract makes its subsequent dissection easy with minimal disruption of adjacent structures.

scholarly journals Effectiveness of the ligation of intersphincteric fistula tract (LIFT) in the treatment of anal fistula: initial results

2014 ◽  
Vol 27 (2) ◽  
pp. 101-103 ◽  
Author(s):  
Sergio Danilo Tanahara TOMIYOSHI ◽  
Carlos Henrique Marques DOS SANTOS
Keyword(s):  
Fecal Incontinence ◽  
Anal Fistula ◽  
Anorectal Manometry ◽  
Fistulous Tract ◽  
Complete Healing ◽  
Fistula Tract ◽  
Anal Fistulas ◽  
Intersphincteric Fistula ◽  
The Mean ◽  
Initial Results

BACKGROUND: The abscesses and anal fistulas represent about 70% of perianal suppuration, with an estimated incidence of 1/10000 inhabitants per year and representing 5% of queries in coloproctology. AIM: To evaluate the effectiveness of the interesphincteric ligation technique of the fistulous tract in the treatment of anal fistula. METHODS: The records of eight patients who underwent this technique, evaluating age, gender and presence of incontinence were studied. Was named technical first-step the passage of cotton thread to promote the correct individualization of the fistula and, as the second, the surgical procedure. RESULTS: Two patients were men and eight women. The mean age was 42.8 years. Of these, seven (87.5%) had complete healing of the fistula; six were cured only with this procedure and one required additional operation with simple fistulotomy. Only one patient developed fecal incontinence which was documented by anorectal manometry. There were no deaths in this series. CONCLUSION: The interesphincteric ligation technique of the fistulous tract proved to be effective for the treatment of anal fistula and should not be discouraged despite the occurrence of eventual fecal incontinence.

scholarly journals A comparative study in the management of fistula in ANO using various modalities

2018 ◽  
Vol 5 (6) ◽  
pp. 2223 ◽  
Author(s):  
Ramachandra M. L. ◽  
Mayank Garg
Keyword(s):  
Fistulous Tract ◽  
Selection Method ◽  
Fistula Tract ◽  
Internal Opening ◽  
Necrotic Tissue ◽  
Fistula In Ano ◽  
Sphincter Function ◽  
Medical College ◽  
Operative Complications ◽  
Comparative Prospective Study

Background: Fistula in ano is a track that connects deeply the anal canal or rectum to the skin around the anus. Fistula in ano most commonly follows an anorectal sepsis1. The main principles of management of anal fistula are closure of internal opening of fistula tract, drainage of infection or necrotic tissue, and eradication of fistulous tract with preservation of sphincter function. The objectives were to compare the various aspects like per operative complications, post-operative complications, mean hospital stay in the treatment of fistula in ano using various modalities like fistulotomy, fistulectomy, setons and lift procedure.Methods: This is a randomised, comparative, prospective study of 80 cases of fistula in ano, presenting at surgical opd of K.R. Hospital, Mysore attached to Mysore Medical College and research Institute. Out of which, 20 cases are treated by fistulectomy, 20 by seton, 20 by fistulotomy and the rest 20 cases by LIFT procedure by random selection method, during period of NOVEMBER 1, 2016 to 31st October 2017.Results: Most common age of presentation is 31-40 years and more common in males then females (M:F= 2.3:1 ). Per operative complications include bleeding seen more in patients undergoing fistulectomy. Per operative course of LIFT procedure patients was complication free. Postoperative pain seen more in patients undergoing setons procedure.Conclusions: we conclude that LIFT procedure and Fistulotomy were acceptable procedures for simple, uncomplicated low lying and high lying fistula.

scholarly journals Pediatric congenital buttock sinus tract:10-year experience in a single institution

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kai Wang ◽  
Chunhui Peng ◽  
Wenbo Pang ◽  
Dayong Wang ◽  
Tingchong Zhang ◽  
...  
Keyword(s):  
Dermoid Cyst ◽  
Epidermoid Cyst ◽  
Treatment Time ◽  
Recurrent Infection ◽  
Sinus Tract ◽  
Fistula Tract ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Retrorectal Space ◽  
First Onset

Abstract Purpose To review our experience with pediatric congenital buttock sinus tract, and to conclude the clinical characteristics and management of the disease. Methods Twenty-two pediatric patients diagnosed with congenital buttock sinus tract were included. Medical records were reviewed, and the patients were followed up. Continuous variables were presented by median and range. Categorical variables were presented as frequencies and percentages. Results Among the 22 patients, there were 8 boys (36.4%) and 14 girls (63.6%). The median first onset age was 42 months, and the range was 5 months to 12 years old. Admission age was 69.5 months, with a range from 14 months to 12 years old. Overall prior treatment time was 11 months, ranging from 3 months to 11 years. Twenty-one patients had definite congenital dimples since birth, and later manifested with infection through the dimple. All patients came to the doctor with complaint of the infection. The number of invasive procedures ranged from 0 to 5, with an average of 2. Radiology could exactly display the morphology and show the termination as a retrorectal cyst. The surgical procedure was adopted trans-fistula tract, and the pathological results showed a dermoid cyst in 11 patients and an epidermoid cyst in 10 patients. During the follow-up period of 34.5 months (range, 2 months to 8 years), 19 patients were uneventful and 3 patients suffered recurrence. Two of them underwent a second operation and had no recurrence ever since. The third patient did not receive a second operation, and the refractory infection was still present. Conclusions Pediatric congenital buttock sinus tract is rare and has a female predominance in the morbidity. Patients have a distinctive congenital dimple on the buttock with recurrent infection, and there usually exists a congenital sinus tract from the dimple to the retrorectal space. Total excision is the only method for the cure. The nature of the disease is a retrorectal developing dermoid cyst or epidermoid cyst.

scholarly journals A prospective interventional study on ligation of intersphincteric fistula tract in patients with fistula-in-ano-as a tertiary care centre

2021 ◽  
Vol 8 (3) ◽  
pp. 968
Author(s):  
Pradeep Panwar ◽  
Richa Jain ◽  
Mohit Jain ◽  
Rajendra Bagree ◽  
Hetish M. Reddy ◽  
...  
Keyword(s):  
Anal Incontinence ◽  
Single Case ◽  
Fistulous Tract ◽  
Tertiary Care ◽  
Healing Time ◽  
Sphincter Preservation ◽  
Fistula Tract ◽  
Tertiary Care Centre ◽  
Fistula In Ano ◽  
Wound Healing Time

Background: Fistula-in-ano is a very common condition encountered in proctology OPD. The treatment of fistula-in-ano is difficult due to potential risk of recurrence and fecal incontinence. Ligation of Intersphincteric Fistulous Tract is new modality of treatment for the condition. LIFT is a sphincter preserving surgery, aim of our study to evaluate the effectiveness of LIFT surgery.Methods: We did LIFT surgery in 35 cases of intersphincteric and transsphincteric types of fistula-in-ano during the period of December 2019 to July 2020. Standard investigation protocol was followed in all cases. Evaluation of effectiveness of procedure done in terms of anal incontinence, wound healing time, recurrence rate and wound infection rate.Results: 35 patients (23 men, 12 women) were included with mean age of 40 SD 10.38 years. Most of study population have Inter sphincteric fistula (62.9%), and 37.1% participants have trans sphincteric fistula. Healing time was 10-15 days (42.9%) and mean healing time is 17 SD 4.25 days. We didn’t see a single case of anal incontinence with LIFT in our study. 6 cases of recurrence were seen.Conclusions: Result from our study showed that LIFT surgery is effective modality and fulfilling the outcome of sphincter preservation.

scholarly journals Evaluation of Fistulotomy with Immediate Sphincteric Reconstruction in the Treatment of High Transsphincteric Perianal Fistula

2021 ◽  
Vol 41 (03) ◽  
pp. 217-221
Author(s):  
Yasser A. Orban ◽  
Hossam Hassan Soliman ◽  
Ahmed M. El Teliti ◽  
Ali El-Shewy ◽  
Yasmine Hany Hegab ◽  
...  
Keyword(s):  
Fistulous Tract ◽  
Perianal Fistula ◽  
Complete Healing ◽  
University Hospital ◽  
Direct Access ◽  
Fistula Tract ◽  
Recurrence Rates ◽  
Fistula Treatment ◽  
High Perianal Fistula ◽  
Sphincteric Reconstruction

Abstract Background High perianal fistula treatment remains challenging, mainly due to the variability in success and recurrence rates as well as continence impairment risks. So far, no procedure can be considered the gold standard for surgical treatment. Yet, strong efforts to identify effective and complication-free surgical options are ongoing. Fistulotomy can be considered the best perianal fistula treatment option, providing a perfect surgical field view, allowing direct access to the source of chronic inflammation. Controversy exists concerning the risk of continence impairment associated with fistulotomy. The present study aimed to assess the outcomes of fistulotomy with immediate sphincteric reconstruction regaring fistula recurrence, incontinence, and patient satisfaction. Methods This interventional study was performed at the General Surgery Department of Zagazig University Hospital during the period from July 2018 to December 2019 on 24 patients with a clinical diagnosis of high transsphincteric fistula-in-ano. The fistulous tract was laid open over the probe placed in the tract. After the fistula tract had been laid open, the tract was curetted and examined for secondary extensions. Then, suturing muscles to muscles, including the internal and external sphincters, by transverse mattress sutures. Results Our study showed that 2 patients develop incontinence to flatus ∼ 8.3%.and only one patient develop incontinence to loose stool, 4.2%. Complete healing was achieved in 83% and recurrence was 16.6%. Conclusion Fistulotomy with immediate sphincteric reconstruction is considered to be an effective option in the management of high perianal fistula, with low morbidity and high healing rate with acceptable continence state.

scholarly journals LIGATION OF INTERSPHINCTERIC FISTULA TRACT AS AN ALTERNATIVE TREATMENT FOR PERIANAL FISTULA AT TERTIARY CARE HOSPITAL

2021 ◽  
Vol 3 (3) ◽  
pp. 53-58
Author(s):  
Nawaz Ali Dal ◽  
Ishrat Raheem Katyar ◽  
Mohammad Qasim Mallah ◽  
Ahsan Laghari ◽  
Shiraz Shaikh ◽  
...  
Keyword(s):  
Fistulous Tract ◽  
Tertiary Care ◽  
Perianal Fistula ◽  
Perianal Abscess ◽  
Sampling Technique ◽  
Fistula Tract ◽  
Care Hospital ◽  
Therapeutic Success ◽  
Preoperative Symptom ◽  
Intersphincteric Fistula

This study was aimed to evaluate clinical outcome of patients with perianal fistula operated with the ligation of intersphincteric fistula tract (LIFT) technique. The study was conducted at Department of Surgery, Liaquat University of Medical & Health Sciences, Jamshoro from July 2018 and August 2019. A total of 22 patients diagnosed with perianal fistula operated with the Ligation of Intersphincteric Fistula Tract (LIFT) technique were selected using non-probability consecutive sampling technique. Physical examination and magnetic resonance imaging (MRI) and/or endosonography (ES) were performed to make a confirmed diagnosis of fistula. They were classified according to Parks classification. All patients were subjected to intersphincteric fistulous tract ligation using the technique defined by Rojanasakul modified. There were 16 males and 6 females. Mean age was 42 years (range 23-68 years of age). Out of 22 patients, 17 patients had a history of perianal abscess drainage prior to surgery and an average preoperative symptom presentation was 2.2 years (range 0-10 years). Therapeutic success with first surgery was achieved in 77% and with a second surgery in 90%. None of this patients modified their preoperative Wexner. It was concluded that LIFT technique appears to be a convenient, reproducible, and effective surgical alternative. This provides an appropriate closing rate and without continence modification, Therefore indicated for complex cryptoglandular fistulas.  

scholarly journals Pediatric congenital buttock sinus tract: 10-year experience in a single institution

2019 ◽  
Author(s):  
Kai Wang ◽  
Chunhui Peng ◽  
Wenbo Pang ◽  
Dayong Wang ◽  
Tingchong Zhang ◽  
...  
Keyword(s):  
Dermoid Cyst ◽  
Epidermoid Cyst ◽  
Treatment Time ◽  
Recurrent Infection ◽  
Sinus Tract ◽  
Fistula Tract ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Retrorectal Space ◽  
Retrorectal Cyst

Abstract Purpose: To review our experience with pediatric congenital buttock sinus tract, and to conclude the clinical characteristics and management of the disease. Methods: Twenty-two pediatric patients diagnosed with congenital buttock sinus tract were included. Medical records were reviewed, and the patients were followed up. Continuous variables were presented by median and range. Categorical variables were presented as frequencies and percentages. Results: Among the 22 patients, there were 8 boys (36.4%) and 14 girls (63.6%). The median first onset age was 42 months, and the range was 5 months to 12 years old. Admission age was 69.5 months, with a range from 14 months to 12 years old. Overall prior treatment time was 11 months, ranging from 3 months to 11 years. Twenty-one patients had definite congenital dimples since birth, and later manifested with infection through the dimple. All patients came to the doctor with complaint of the infection. The number of invasive procedures ranged from 0 to 5, with an average of 2. Radiology could exactly display the morphology and show the termination as a retrorectal cyst. The surgical procedure was adopted trans-fistula tract, and the pathological results showed a dermoid cyst in 11 patients and an epidermoid cyst in 10 patients. During the follow-up period of 34.5 months (range, 2 months to 8 years), 19 patients were uneventful and 3 patients suffered recurrence. Two of them underwent a second operation and had no recurrence ever since. The third patient did not receive a second operation, and the refractory infection was still present. Conclusions: Pediatric congenital buttock sinus tract is rare and has a female predominance in the morbidity. Patients have a distinctive congenital dimple on the buttock with recurrent infection, and there usually exists a congenital sinus tract from the dimple to the retrorectal space. Total excision is the only method for the cure. The nature of the disease is a retrorectal developing dermoid cyst or epidermoid cyst. Keywords: Pediatric, Buttock sinus tract, Retrorectal cyst, Treatment, Prognosis

Spontaneous Cholecystocutaneous Fistula: A rare clinical Entity

2019 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Amit Gupta ◽  
Manoj Joshua ◽  
Navin Kumar ◽  
Udit Chauhan ◽  
Sweety Gupta
Keyword(s):  
Gall Bladder ◽  
Histopathological Examination ◽  
Open Cholecystectomy ◽  
Fistulous Tract ◽  
Gall Stone ◽  
Stone Disease ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
The Right ◽  
Operative Recovery

Introduction: Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bladder stone disease infrequently seen in surgical practice due to early diagnosis of gall stone disease with imaging and appropriate and prompt antibiotic and surgical treatment. Case report: We report our experience with a 40-year-old woman who presented with a yellowish discharge from the umbilicus. Abdominal examination revealed a sinus opening at the umbilicus with the yellowish discharge and a vague mass in the right hypochondrium. CT fistulogram showed tract extending form the umbilicus to the gall bladder. Open cholecystectomy with excision of the fistulous tract was carried out. Histopathological examination showed chronic inflammation of the gall bladder with the fistulous tract lined by inflammatory granulation tissue. Post-operative recovery was normal and uneventful. The patient was normal in follow-up. Cholecystocutaneous fistula is a rare clinical entity. The diagnosis is established with CT and MRCP. Surgery remains the mainstay of treatment.

scholarly journals Pediatric congenital buttock sinus tract: 10-year experience in a single institution

2019 ◽  
Author(s):  
Kai Wang ◽  
Chunhui Peng ◽  
Wenbo Pang ◽  
Dayong Wang ◽  
Tingchong Zhang ◽  
...  
Keyword(s):  
Dermoid Cyst ◽  
Epidermoid Cyst ◽  
Treatment Time ◽  
Recurrent Infection ◽  
Sinus Tract ◽  
Fistula Tract ◽  
Retrorectal Space ◽  
Female Predominance ◽  
First Onset ◽  
Retrorectal Cyst

Abstract Background: Pediatric congenital buttock sinus tract has rarely been reported, and the manifestations, treatments, and prognosis of such patients remain unknown. The purpose of this study is to review our experience with this disease, and to conclude the clinical characteristics and management of the disease. Methods: Twenty-two pediatric patients diagnosed with congenital buttock sinus tract were included. Medical records were reviewed, and the patients were followed up. Data were presented using the mean ± standard deviation, median (first quartile, third quartile), frequencies and percentages as appropriate. Results: Among the 22 patients, there were 8 boys (36.4%) and 14 girls (63.6%). First onset age was 42.00 (12.00, 84.00) months, admission age was 77.77 ± 40.73 months, and overall prior treatment time was 11.00 (6.50, 33.75) months. Twenty-one patients had definite congenital dimples since birth, and later manifested with infection through the dimple. All patients came to the doctor with complaint of the infection. The number of invasive procedures ranged from 0 to 5, with an average of 2. Radiology could exactly display the morphology and show the termination as a retrorectal cyst. The surgical procedure was adopted trans-fistula tract, and the pathological results showed a dermoid cyst in 11 patients and an epidermoid cyst in 10 patients. During the follow-up period of 34.50 (24.25, 87.50) months, 19 patients were uneventful and 3 patients suffered recurrence. Two of them underwent a second operation and had no recurrence ever since. The third patient did not receive a second operation, and the refractory infection was still present. Conclusions: Pediatric congenital buttock sinus tract is rare and has a female predominance in the morbidity. Patients have a distinctive congenital dimple on the buttock with recurrent infection, and there usually exists a congenital sinus tract from the dimple to the retrorectal space. Total excision is the only method for the cure. The nature of the disease is a retrorectal developing dermoid cyst or epidermoid cyst. Keywords: Pediatric, Buttock sinus tract, Retrorectal cyst, Treatment, Prognosis

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