ABSTRACT
Definitive emergency surgical treatment of an acute pilonidal abscess by excision of the squamous epithelial sinus or sinuses with drainage of the abscess has given excellent results. Although the procedure can be done in the office, it is best carried out in the hospital operating room with the use of local anesthetics. The great advantage of this method is that only one surgical procedure is required and the morbidity usually associated with this disease is lessened. The abscess has not recurred in patients so treated. The hospital cost is low, and the patient loses a minimal amount of time from work or school.
Subject(s)
Abscess/etiology , Pilonidal Sinus/complications , Postoperative Care , Abscess/surgery , Acute Disease , Bandages , Humans , Methods , Pilonidal Sinus/surgery , Wound HealingABSTRACT
Small percentages of anorectal abscesses and of chronic fistula in ano are supralevator, resulting from a high intermuscular abscess caused by infected anal glands or chronic ulcer of the anus. The disease is not to be confused with a pelvic abscess caused by other factors. The recommended treatment is internal sphincterotomy to permit drainage at the site of perforation in the longitudinal muscle into the rectum. On rare occasions, in critically ill patients, additional drainage of the pelvic abscess may be necessary through the fossa ischiorectalis or by a lumbar-retroperitoneal space approach.
Subject(s)
Abscess/diagnosis , Proctitis/diagnosis , Rectal Fistula/diagnosis , Abscess/surgery , Anal Canal/surgery , Female , Humans , Male , Muscles/surgery , Proctitis/surgery , Rectal Fistula/surgerySubject(s)
Abscess/surgery , Anus Diseases/surgery , Rectal Diseases/surgery , Rectal Fistula/surgery , Abscess/classification , Abscess/pathology , Anus Diseases/classification , Anus Diseases/pathology , Humans , Methods , Rectal Diseases/classification , Rectal Diseases/pathology , Rectal Fistula/classification , Rectal Fistula/pathologyABSTRACT
An elastic seton has been used in more than 35 patients in the surgical management of anterior abscess-anal fistula and anterolateral anal fistula in women. Elastic setons are applicalbe in the treatment of other complicated abscess-anal fistulas. The advantage of this method is the good functional result, with a minimal deformity of the anus. The treatment can be administered with a minimal number of hospital days or, in some instances, on an outpatient basis.
Subject(s)
Abscess/surgery , Rectal Fistula/surgery , Surgical Equipment , Abscess/complications , Drainage , Female , Humans , Methods , Perineum/surgery , Rectal Fistula/complications , RubberSubject(s)
Colon , Endoscopy , Colonic Diseases/diagnosis , Colonic Diseases/therapy , Fiber Optic Technology , HumansABSTRACT
A preliminary report in 1965 described a conservative surgical procedure for the management of acute and chronic horseshoe anal fistulas. The operation has been used exclusively at the Ochsner Clinic for this problem since 1963. Forty-one patients were treated from 1963 to 1973. The paper reviews the pathology of acute and chronic horseshoe anal fistulas and describes the surgical procedure for both acute and chronic horseshoe abscess anal fistulas with accompanying illustrations. The excellent results with minimal deformity of the anus and anal canal are attributed to avoidance of severing the superficial external sphincter between its coccygeal origin and the anus. Of the 41 patients treated in the period from 1963 to 1973, healing was good, and there has been no recurrence.
