Abstract
To determine whether primary fistulotomy should be performed at the time of incision and drainage of anorectal abscesses, a retrospective study of 117 patients who underwent incision and drainage of anorectal abscesses was conducted to ascertain what percentage of patients would subsequently develop a fistula-in-ano or recurrent abscess. None of the patients treated for intersphincteric abscesses developed recurrences. Of the 83 patients with perianal or ischiorectal abscesses, nine (11 per cent) developed recurrent abscesses and 31 (37 per cent) developed persistent fistula-in-ano for a combined persistence or recurrence rate of 48 per cent. These data support the policy of secondary fistulotomy to avoid division of sphincter muscle in the 52 per cent of patients who would not need it. In addition, the vast majority of perianal and ischiorectal abscesses can be drained under local anesthesia and hence a general anesthetic and hospital admission are obviated.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abcarian H. Acute suppurations of the anorectum. In: Nyhus LM, ed. Surgery annual. New York: Appleton Century Crofts 1976; 8:305.
Abcarian H. Surgical management of recurrent anorectal abscesses. Contemp Surg 1982;21:85–91.
Hanley PH. Anorectal abscess fistula. Surg Clin North Am 1978;58:487–503.
McElwain JW, Maclean D, Alexander RM, Hoexter B, Guthrie JF. Anorectal problems: experience with primary fistulotomy for anorectal abscess, a report of 1000 cases. Dis Colon Rectum 1975;18:646–9.
Read DR, Abcarian H. A prospective survey of 474 patients with anorectal abscess. Dis Colon Rectum 1979;22:566–9.
Waggener HU. Immediate fistulotomy in treatment of perianal abscess. Surg Clin North Am 1969;49:1227–33.
Goldberg SM, Gordon PH, Nivatvongs S. Essentials of anorectal surgery. Philadelphia: JB Lippincott, 1980,8:100.
Goldberg SM, Parks AG, Goligher JC, Alexander-Williams J, Hanley PH. Symposium: fistula-in-ano. Dis Colon Rectum 1976;19:487–528.
Lockhart-Mummary HE. Symposium: anorectal problems: treatment of abscess. Dis Colon Rectum 1975;18:650–1.
Scoma JA, Salvati EP, Rubin RJ. Incidence of fistulas subsequent to anal abscesses. Dis Colon Rectum 1974;17:357–9.
Bevans DW, Westbrook KC, Thompson BW, Caldwell FT. Perirectal abscess: a potentially fatal illness. Am J Surg 1973;126:765–8.
Buchan R, Grace RH. Anorectal suppuration; the results of treatment and factors influencing the recurrence rate. Br J Surg 1973;60:537–40.
Kovalcik PJ, Peniston RL, Cross GH. Anorectal abscess. Surg Gynecol Obstet 1979;149:884–6.
Lindell TD, Fletcher WS, Krippaehne WW. Anorectal suppurative disease, a retrospective review. Am J Surg 1973;125:189–94.
Hughes ES. Inflammations and infections of the anus. In: Turell R, ed. Diseases of the colon and anorectum. 2nd ed. Philadelphia: WB Saunders, 1969, 44:955.
Eisenhammer S. The internal anal sphincter and the anorectal abscess. Surg Gynecol Obstet 1956;103:501–6.
Parks AG. Pathogenesis and treatment of fistula-in-ano. Br Med J 1961;1:463–9.
Parks AG, Thompson JP. Intersphincteric abcess. Br Med J 1973;2:537–9.
Chrabot CM, Prasad ML, Abcarian H. Recurrent anorectal abscesses. Dis Colon Rectum 1983;26:105–8.
Author information
Authors and Affiliations
Additional information
Read at the meeting of the American Society of Colon and Rectal Surgeons, Boston, Massachusetts, June 5 to 9, 1983.
About this article
Cite this article
Vasilevsky, CA., Gordon, P.H. The incidence of recurrent abscesses or fistula-in-ano following anorectal suppuration. Dis Colon Rectum 27, 126–130 (1984). https://doi.org/10.1007/BF02553995
Issue Date:
DOI: https://doi.org/10.1007/BF02553995