Anal Abscess and Fistula:

Anal abscess (breech abscess) occurs with the inflammation of the glands secreting in the anus and the accumulation of inflammation. it grows and grows east next to the breech. swelling becomes visible from the outside. fever, weakness, severe pain develop. The swelling that develops near the breech can cause a foul-smelling discharge to the outside. Due to swelling, it gives complaints similar to hemorrhoids, but discharge and fever are usually seen in the fistula.

The abscess may burst spontaneously or, when diagnosed, be drained with medication or intervention. After ejaculation, there will be a discharge for a while, the complaints will pass over time. however, a channel is usually formed between the point where the abscess starts in the anus and the hole where it empties out. This canal is called a fistula. A flow develops from the fistula towards the external hole. There is a possibility of re-inflammation of the area, in such cases the color, consistency and smell of the discharge changes. In inflammatory periods, new abscess foci may develop around the fistula, and these foci may cause new fistula lines. therefore, the fistula line becomes multi-channel and complex.

Diagnosis is usually made by examination. however, when a complex fistula structure is suspected or the presence of a fistula is suspected, MRI and endoscopy are used.

In the treatment, if there is inflammation, it should be removed first, and if there is an abscess, it should be drained. If fistula is present, treatment is surgical intervention. these interventions:

1-classical method: the area between the inner hole and the outer hole of the fistula is opened, the foci of inflammation are cleaned. some surgeons also want to remove the fistula line if possible. The inner mouth of the fistula usually passes between the muscles holding the anus. therefore this muscle tissue should be cut as well. In elderly patients, if the breech muscles are relaxed, this may be a problem. Therefore, a special thread can be used (seton) to cut the muscle tissue that needs to be cut. Many surgical techniques have been developed to correct this situation. Wound healing time varies depending on patient-related factors (such as the presence of diabetes), the size of the wound and the presence of an inflammatory area, but it is 2-4 weeks. Requires constant dressing.

2-laser fistula surgery: the inner mouth of the fistula is closed with sutures. fistula line is scraped and cleaned. The entire fistula line is burned with a laser. The outer mouth is removed and made into an open wound.

In all surgical techniques, there is a risk of recurrence at different rates or fistula formation from another part of the anus. The surgical method should be chosen according to the characteristics of the patient and the condition of the abscess-fistula.

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