A Retrospective Study of Incidence of Fistula after Management of Perianal Abscess

Abstract

Background: Perianal fistulas can present significant morbidity and detriment to a patient’s quality of life. Perianal fistula is among the most common anorectal diseases encountered in adults, men are more prone to be affected than women. Objective: To determine the incidence of fistula After Management of Perianal Abscess. Materials and Methods: A retrospective study of 34 patients with perianal abscess operations conducted in Dept. of Surgery, Sheikh Hasina Medical College and Hospital, Tangail, Bangladesh from January 2017 to December 2021. Their ages ranged from 20 to 68 years (40.21 ± 1.34) males (31/34) (92.64%) were more than females (3/34) (7.35%). Patients were treated with incision over the abscess under anesthesia and drainage of the abscess was done. The patients were followed up for an average 18 months (range 12–24 months) after abscess drainage or until a fistula appeared and abscess recurrence. Results: The study group comprised of 34 (92.64%) patients with perianal abscess with a median age 39 years (range 20–68 years). The mean follow-up period was identified to be 18 months (range 12–24 months). Males (31/34) (92.64%) were more than females (3/34) (7.35%). The incidence of fistula formation after follow up, the patients with perianal abscess after incision and drainage was 16/34 (47.07%) and males (15/16) (44.11%) were more than females (1/16) (2.94%). The most common site was posterior then left lateral position. The percentage of patients with recurrent abscess n = 3 (8.82%) were lower than fistula formation n =16 (47.07%). The percentage of males n = 2/3 (5.88%) were more than females 1/3 (2.94%). Conclusions: The incidence of anal fistula in a sample of Bangladeshi patients with perianal abscess was 47.05% and percentage of recurrence of perianal abscess was 8.82%. To avoid division of anal sphincter muscle, secondary fistulotomy is advised to be done later when anal fistula will be formed.