Diseases of the Colon & Rectum

, Volume 41, Issue 11, pp 1357–1361 | Cite as

Incidence of fistulas after drainage of acute anorectal abscesses

  • Kari-Pekka J. Hämäläinen
  • A. Peter Sainio
Original Contributions

Abstract

PURPOSE: The aim of this study was to assess the incidence of anal fistulas and factors related to this incidence after incision and drainage of acute cryptoglandular anorectal abscesses. METHODS: Of 170 patients without previous anal fistulas, 146 were followed up for an average of 99 (range, 22–187) months after abscess drainage or until a fistula appeared. RESULTS: Fifty-four (37 percent) patients developed a fistula, and 15 (10 percent) patients developed a recurrent abscess. The incidence of fistulas was higher in females than in males (50vs. 31 percent;P=0.0403), especially regarding anterior abscesses (88vs. 33 percent). Abscesses growingEscherichia coli were more prone to fistula formation than those growing other bacteria (46vs. 27 percent;P=0.0368). CONCLUSION: Incision and drainage alone of acute anorectal abscesses is recommended, because an unnecessary primary fistulotomy can be avoided in more than half of the patients by this approach. For superficial anterior abscesses in females, however, primary fistulotomy may be considered.

Key words

Anorectal abscess Anal fistula Surgical treatment 

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Copyright information

© The American Society of Colon and Rectal Surgeons 1998

Authors and Affiliations

  • Kari-Pekka J. Hämäläinen
    • 1
  • A. Peter Sainio
    • 1
  1. 1.From the Fourth Department of SurgeryHelsinki University Central HospitalHelsinkiFinland

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