Recurrent high fistula-in-ano: Think of tuberculosis!

Dawar, Reetika; Jain, Sushil K.; Rani, H L; Mendiratta, Leena; Sardana, Raman

doi:10.4103/1755-6783.184808

Cited by 2 publications

(3 citation statements)

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“…16 Any chronic inflammatory lesion should be suspected and investigated for tuberculosis as tuberculosis is still common in India. 17 10.67% of the patients had recurrence after surgery which was similar to the study by Emile et al (7.4%). Of the eight patients who had recurrent fistula, 6 had tuberculosis.…”

Section: Discussionsupporting

confidence: 88%

A study on clinicopathology of fistula in ano

Phinehas

Mayandi²,

Ravishankar³

2018

Int Surg J

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Background: Perianal fistula is a common surgical problem which poses great discomfort to patients and causes prolonged morbidity when improperly managed or developed complications. Its management protocols are ill defined, and the efficacy of newer treatment modalities are not well established. The aim of the study was to study the clinicopathology of Perianal fistula and its prognostic factors.Methods: This was a prospective study conducted at the Department of General Surgery, Rajiv Gandhi Government General Hospital between August 2014 and July 2015. Purposive sampling method was used select patients with fistula in ano. After obtaining informed consent, patient details were collected in pre-tested structured questionnaire. Data entry and analysis were done using SPSS software.Results: Males between thirty and fifty years were the most affected population. Most of the patients had no co-morbidities while Diabetes Mellitus was the prevalent co-morbid factor, seen especially in the elderly. MRI fistulogram was the investigation of choice. Fistulotomy was the preferred procedure. Recurrence of fistula was an unavoidable morbidity.Conclusions: Proper preoperative evaluation which includes MRI fistulogram and planning the treatment is essential to prevent complications. Fistulotomy is the preferred treatment especially in patients with trans-sphincteric fistula and those with evidence of infection or secondary tract. The prognosis, if properly managed is very good, so proper management protocols need to be established.

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Section: Discussionsupporting

confidence: 88%

A study on clinicopathology of fistula in ano

Phinehas

Mayandi²,

Ravishankar³

2018

Int Surg J

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“…Culture is positive in only 36% of patients with rectal TB. 24 In a study by Shukla et al on 122 patients with fistulae-in-ano operated upon in a 5 year period, 15.6% were found to have tubercular fistulae on histopathological examination. 25 Real time polymerase chain reaction (RT-PCR) for pus or fistula tissue has also been used to detect tuberculosis in suspected cases.…”

Section: Prevalence Of Tuberculosis In Fistula In Anomentioning

confidence: 98%

“…Tuberculous fistulae-inano have been reported in India, France, Africa, Japan, Australia, Germany, Turkey, and the United Kingdom. 24 Unfortunately, there is no clinical sign or preferred site that allows a tuberculous fistula to be distinguished from a crypto glandular fistula. It should be suspected in patients with constitutional symptoms, lesions with caseous discharge, undermined edges, fistula not responding to conventional treatment, recurrent, multiple or complex fistulae and patients with anorectal strictures & inguinal lymphadenopathy.…”

Section: Prevalence Of Tuberculosis In Fistula In Anomentioning

confidence: 99%

A prospective study of fistula in ano with reference to clinicopathology, imaging and management

Saxena¹,

Yadav²

2019

Int Surg J

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Background: The aim was to study and review clinical presentation, pathological aspects & prevalent modalities of investigation and treatment for fistula in ano.Methods: A prospective study of 90 patients of fistula in ano admitted from March 2015 to December 2016 was done. Fistulography was done as a preliminary investigation in 72 cases and MR Fistulography was done for complex and recurrent fistula (16 cases). Patients were operated and histopathology of fistula tract was done. In patients with clinical suspicion of tuberculosis smear examination of pus with ziehl neelsen staining for acid fast bacilli (AFB) and Cartridge Based Nucleic Acid Amplification Test (CBNAAT) on pus/slide was used to find out tuberculosis in patients of anal fistula. The clinical presentation, operation performed, pathological findings were recorded & a descriptive analysis was done.Results: A prospective study of 90 patients of fistula in ano admitted from March 2015 to December 2016 was done. Fistulography was done as a preliminary investigation in 72 cases and MR Fistulography was done for complex and recurrent fistula (16 cases). Patients were operated and histopathology of fistula tract was done. In patients with clinical suspicion of tuberculosis smear examination of pus with ziehl neelsen staining for acid fast bacilli (AFB) and Cartridge Based Nucleic Acid Amplification Test (CBNAAT) on pus/slide was used to find out tuberculosis in patients of anal fistula. The clinical presentation, operation performed, pathological findings were recorded & a descriptive analysis was done.Conclusions: With careful clinical evaluation, appropriate imaging studies and conventional surgical techniques anal fistula can be treated effectively with less morbidity, incontinence and recurrence.

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Recurrent high fistula-in-ano: Think of tuberculosis!

Cited by 2 publications

References 1 publication

A study on clinicopathology of fistula in ano

A study on clinicopathology of fistula in ano

A prospective study of fistula in ano with reference to clinicopathology, imaging and management

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