Clinical Gastroenterology Vol.25 No.1(4-2)

Theme Current Topics Relating to the Anus
Title Benign AnorectalDiseases -- Recent Information on Anal Fistulas
Publish Date 2010/01
Author Hiroyuki Kurihara Tokorozawa Proctologic Hospital
Author Tadao Kanai Tokorozawa Proctologic Hospital
Author Toru Ishikawa Tokorozawa Proctologic Hospital
Author Shinichiro Kanai Tokorozawa Proctologic Hospital
Author Moon-Sung Chang Tokorozawa Proctologic Hospital
Author Ryota Kanai Tokorozawa Proctologic Hospital
Author Toshihiko Kuroda Tokorozawa Proctologic Hospital
[ Summary ] Anorectal abscess originate from infections in the anal canal. After the abscess is cured through surgical drainage or by natural courses, a cicatricial tract, which is termed a fistula, may be formed. Many doctors feel that it is difficult to diagnose or treat anorectal abscesses and fistulas, because they are multi-dimensional and exhibit various symptoms according to the degree of inflammation. It is necessary to understand the usual pathological features of related diseases to diagnose critical anal diseases, such as Crohn's anus.
This paper presents our new classification of fistulas to clarify the definition of low intersphincteric fistula and posterior complex fistula. Moreover, the conditions and symptoms usually associated with periproctal abscesses and fistulas are presented based on this classification. Diagnostic methods, especially inspections and digital examinations, are presented. Critical anal diseases such as necrotizing infections of the soft tissue and fistula related cancer are also outlined.
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