Anal Abscess / Anal Fistula
Anal abscess and anal fistula are part of the same disease process.
The progression of this is shown in the pictures below.
The problem
is the result of infection in an anal gland. These glands surround
the anus and secrete small quantities of fluid.
Alternatively a fissure in ano (a small crack in the anal lining)
becomes infected.
A cavity filled with pus forms and becomes larger and painful.
The patient becomes feverish and feels ill. Eventually it comes
close to the skin as shown above.
If the abscess bursts or is opened by the doctor pus discharges.
The picture above shows the small opening from which the pus
emerges lessening the pain.
The discharging cavity is called a sinus. The sinus above can
be penetrated with a fine metal implement called a probe.
If the abscess also bursts into the anal canal it is called
a fistula. A fistula is a narrow tunnel which connects the skin
outside with the anal canal. The picture above shows a probe
going through such a tunnel.
A fistula is not particularly painful
but continues to secrete
pus causing irritation and discomfort. If the exits to the
fistula become blocked for any reason the pus accumulates and
the cycle
of painful abscess and fever begins once more.
TREATMENT OF AN ABSCESS
The abscess must be drained to empty the pus
containing cavity. The doctor uses pain relieving sedation and
local anaesthesia
before making an opening to let out the infected fluid, relieving
the painful pressure.
TREATMENT OF A FISTULA
Not all abscesses end up as a fistula
but approximately half of them will cause the complication
which requires an operation
in a day centre. This operation is occasionally performed
in conjunction with the initial abscess procedure. Usually
a second
procedure is needed some weeks or even months later.
The
surgeon opens the entire length of the fistula to form a groove
which can heal from its depth. This operation
is called
Fistulotomy. Rarely a fistula is complex and requires
more than one procedure due to recurrences.
AFTER CARE
This takes place at home with visits to the doctor.
It is similar for abscess and fistula operations. It involves
baths
in warm
water and a pad applied to the region. The patient
returns to work after a few days.
Return to Colonoscopy Information for Patients
|
