# treatment of anal fistula 46280?? tia :)



## MELJNBBRB (Apr 2, 2015)

Pre-operative diagnosis: 
Fistula in ano 


Post-operative diagnosis:  
Trans-sphincteric fistula in ano 


Operations performed: 
Examination under anesthesia with debridement of the fistula tract.  
Placement of seton x 2


Anesthesia: GETA. 


Estimated Blood loss: Less than 10 mL

IV Fluids: 500 cc

Specimen to lab: None

Indications:
a 37 y.o. male with history of perianal pain, bleeding, and abscess. He underwent anoscopy in the office and a fistula was suspected.  He has failed placement of a GORE fistula plug with development of a recurrent abscess/fistula. The risks and perioperative recovery related to examination under anesthesia and treatment of this fistula with a likely seton placement were explained in detail.  The patient gave informed consent to proceed.  

SUMMARY:
The patient was taken the operating room, placed supine on the operating table, and after adequate general tracheal anesthesia was given,  was prepped and draped in usual fashion. The perianal skin was anesthetized using 0.5% Naropin local anesthetic. Anoscopy revealed the previously identified transphincteric anal fistula at the 3 o'clock position. The tract was probed and then cleansed with hydrogen peroxide. The fistula tract was debrided with the curette.  The fistula traversed the sphincters.   2 setons of 0-Tycron were placed through the tract and tied loosely to themselves (non-cutting setons). The anorectum was packed with Gelfoam soaked in 2% xylocaine jelly. He was awakened from general anesthesia after tolerating the procedure well without complications.


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## torifreak12 (Apr 7, 2015)

46060?


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## CELADYBUG13 (Apr 8, 2015)

Take a look at 46280.


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