The Renaissance and the Scientific Revolution
Lois N. Magner, Oliver J. Kim in A History of Medicine, 2017
Thanks to Louis XIV's fistula-in-ano (anal fistula), in 1686 another French surgeon, Charles-François Félix, had a rare opportunity to earn royal patronage and appreciation. (An anal fistula is an infected channel between the skin and the anus.) For many months, physicians subjected the unfortunate king to emetics, purges, leeches, bleedings, and other futile and dangerous remedies. The king's distress was caused by a fecalith that had lodged itself in the royal rectum, causing inflammation, abscesses, and a fistula. Finally, the desperate king turned from medicine to surgery. According to Félix's enemies, the surgeon tested the operation on several patients in a Parisian hospital; some of these human guinea pigs did not survive. Fortunately, the operation on the king was entirely successful. A much relieved and grateful monarch granted royal rewards and favors to France's surgeons, much to the displeasure of the physicians.
Applied Surgical Anatomy
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
How does horseshoe abscess arise from a perianal abscess?This is usually related to an anal fistula.An abscess of the anorectal region may spread from ipsilateral to contralateral side via three routes: Inter-sphincteric abscess via the inter-sphincteric space to the contralateral sideIschiorectal abscess – this spreads posteriorly via the post-anal space to the contralateral sideSupralevator spread – this is rare
Hidradenitis Suppurativa
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
HS affecting the anal canal presents with pain, discharge of pus or blood and perianal swelling.5 The symptoms may resemble anal fistula or perianal abscess. Patients may have a history of multiple operations for recurrent anal fistula. Importantly, anal HS only affects the skin below the dentate line; the internal and external anal sphincters are not involved.26 Patients affected with HS may have multiple or recurrent tracts, and these tracts can involve muscle, fascia and viscera.5 Repeated episodes of HS lead to dense fibrosis around the anus and contracture of the involved skin.
Cytomegalovirus enteritis with intractable diarrhea in infants from a tertiary care center in China
Published in Scandinavian Journal of Gastroenterology, 2020
Yuhuan Wang, Zhiheng Huang, Ziqing Ye, Cuifang Zheng, Zhinong Jiang, Ying Huang
In a report of two patients with CMV enterocolitis and 21 immunocompetent young children with CMV colitis that were reviewed in the literature, the majority of patients were male (73%, 16/22, with one patient with unknown gender information) [3]. In our study, 80.0% (8/10) percent of patients were male, which is potentially suggestive of subtle differences among host immune defenses (X-linked or otherwise) against CMV [3]. In previous reviews, the colon is most commonly affected in CMV colitis, and the rectum is rarely involved [27]. However, in our study, rectal ulcerations were detected in six patients (60%), and one of them also had perianal abscess and anal fistula. Thus, rectum involvement may not be rare, and more cases are needed to assess its phenotype. Typical endoscopic findings of various ulcer types, including punched-out ulcers, irregular ulcers, longitudinal ulcers, and a cobblestone-like appearance, were reviewed in the literature [28,29]. Our study obtained similar results, except for the lack of observation of cobblestone-like appearance.
Fistulectomy and primary sphincteroplasty (FIPS) to prevent keyhole deformity in simple anal fistula: a single-center retrospective cohort study
Published in Acta Chirurgica Belgica, 2021
Nicolas De Hous, Thomas Van den Broeck, Charles de Gheldere
A simple anal fistula was defined as either an intersphincteric or a low transsphincteric fistula crossing <30% of the external anal sphincter [2]. The location of the treated fistula tract was defined according to the location of the external and internal opening in relation to the anus in lithotomy position. Patients with acute perianal sepsis were first treated by incision and drainage with seton placement and had definitive surgery only after acute sepsis had resolved. Data collected consisted of patient age at surgery, sex, smoking, fistula type (according to the Parks classification), fistula etiology (cryptoglandular or retrofissural), fistula location (anterior, lateral, posterior), operative time and previous fistula surgery (number and type).
Jump Technique versus Seton Method for Anal Fistula Repair: A Randomized Controlled Trial
Published in Journal of Investigative Surgery, 2022
Jalaluddin Khoshnevis, Roberto Cuomo, Farzaneh Karami, Terifeh Dashti, Alireza Kalantar Motamedi, Mohammadreza Kalantar Motamedi, Eznollah Azargashb, Negaar Aryan, Payam Sadeghi
The ultimate goal in the treatment of anal fistula is to eliminate the primary or any associated secondary openings and tracts with continence remaining intact [6, 7]. Fistulotomy is the “gold standard” approach for the treatment of anal fistula. For simple fistulae, the recurrence rate subsequent to fistulotomy is generally between 2–9% with a change in continence in 0–17% of patients [8, 9]. Fistulotomy wounds could last for prolonged healing periods, therefore causing significant discomfort, distress and contour defects around the anus in patients [10].
Related Knowledge Centers
- Abscess
- Anal Canal
- Anesthesia
- Anorectal Abscess
- Anoscopy
- Internal Anal Sphincter
- Pruritus Ani
- Pus
- Fistula
- External Anal Sphincter