Peri-anal fistula: bidimensional clinical and operative study

ABSTRACT

The present work was carried out on 100 patients with perianal fistulae to study the relation between the topographic disposition of their external openings and the height of the fistulous track. A history of perianal abscess [PAA] was present in 89% of the cases, surgically drained abscesses resulted in a higher incidence of fistulae with blind extension. Intersphincteric [ISP] fistula was the predominant type, while high ISP fistula without perianal opening [submucous] was least common. No supra or extrasphincteric fistulae were found. 8% of the cases could not be classified according to Park's classification. Goodsall's rule was valid in the majority of cases but not always true. Fistulae located at the transverse line passing through the anus had no rule in their course. Fistulae posterior located at the transverse line passing through the anus had no rule in their course. Fistulae posterior to that line usually open at 6 O'clock, while anterior to it fistulae usually open directly except those with EO at a distance more than 2 cm from MCJ [where they may open posterior at 6 O'clock or anterior at 12 O'clock]