ABSTRACT
Background: Seton is any string-like material which when tied through the fistula tract causes an inflammatory reaction which stimulates fibrosis that fixes and prevents retraction of the sphincter continuity when it is divided. In this way, it maintains sphincter continuity during cutting process
Aim of work: was to evaluate the cable tie seton technique in surgical treatment of high perianal fistula, regarding the rate of fecal incontinences and recurrence
Patients and Methods: This prospective study included a total of 20 cases having single tract, high perianal fistula, primary or recurrent and who were managed by cable tie seton from October 2016 till September 2017. Patients were enrolled from General Surgery Department, Al-Hussein Hospital. Patients were instructed to follow up weekly for 10 weeks with continuous tightening of the seton
Results: All the patients were followed up for the state of incontinence for flatus, liquid and solid stool and follow up for recurrence, slippage of cable: Incontinence: There is 3 cases noticed in early 2 weeks incontinent for flatus. Incontinence for liquid stool noticed in 2 cases in early 1 week. Incontinence for solid stool not noticed in our study. In all cases, the cable tie seton was kept in its position and didn't dislodged or slipped
Conclusion: It could be concluded that cable tie seton is safe, low cost, ubiquitous, pragmatic, precise, and accost effective option for the treatment of high perianal fistula. We there for recommended it for treating fistula in ano requiring the placement of aseton. It does not carry the disadvantages of repeated anesthesia and visits to the operating theater and reduce the morbidity, inconvenience, and cost to the patient
ABSTRACT
Background: biliary obstruction or cholestasis is a common medical or surgical problem. Broadly speaking, the causes can be divided into intrahepatic and extrahepatic. The diagnosis of biliary tree can be done by different imaging modalities starting from transabdominal ultrasonography, to magnetic resonance cholangeopancreatograpy [MRCP] to endoscopic ultrasonography [EUS] and endoscopic cholangeopancreatography [ERCP] for diagnosis and treatment
Aim of the present work: this study aimed to evaluate the accuracy of these different modalities when compared to ERCP as diagnostic methods for diagnosis of different biliary tree abnormalities
Patients and methods: eighty-four patients with obstructive jaundice were included and categorized into two groups group I: 56 patients with calcular obstructive jaundice, group II: 28 patients with non-calcular obstruction. Patients underwent history taking, clinical examination and routine laboratory investigations as well as tumor markers. Patients were examined by US, MRCP, EUS, ERCP and the findings of each modality were compared to ERCP
Results: the sensitivity and specificity of US in diagnosis of intrahepatic biliary dilatation [IHBRD] and common bile duct [CBD] dilatation were 81% , 100% and 33% and 100% for diagnosis of pancreatic tumors respectively. The sensitivity and specificity of MRCP in diagnosis of IHBRD was 97% and 100% successively and for CBD dilatation 79% and 100% successively and for diagnosis of pancreatic tumors 100% and 96% successively. The sensitivity and specificity of EUS in diagnosis of IHBRD were 100% and 100% successively and for CBD dilatation were 100% and 100% successively but in diagnosis of pancreatic tumors were 100% and 94% successively
Conclusion: Both MRCP and EUS were good diagnostic modalities for biliary obstruction and pancreatic tumors with sensitivity and specificity of >90% when compared to ERCP