The morphological picture of anal disease manifestations includes not only the anal fissure, the ul

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The morphological picture of anal disease manifestations includes not only the anal fissure, the ulceration and skin tags abscesses and fistulas following vets liverpool therefrom. The first-mentioned findings are often overlooked because of anal disease is typified as "fistulous" disease. In the case of Crohnabszesse fistulas and a restrictive-conservative approach was recommended earlier for fear of incontinence or non-healing wounds. Today the therapeutic principles are designed more active.
All abscesses must be absolutely open. The purulent comportment destroys the muscular Sphinkterorgan and promotes the development of a generalized septic process. A sole conservative therapy, eg with metronidazole vets liverpool is ineffective.
Among the typical fistula anal fistula can be observed with distal gelegenem muskeldurchbohrendem transition. This "fistulas in Crohn's disease" can be divided mainly according to the usual surgical principles. Atypical vets liverpool "fistulas by the Crohn's disease" vets liverpool that disregard the anatomical boundaries, however, require a conservative therapy. Here you can succeed occasionally a plastic closure of the inner Fistelostiums. Previously, these fistulas can be provided with a temporary thread drainage. The question of a chair off by colostomy or ileostomy for remedying Crohnfistel is still discussed controversially. vets liverpool However, it can generally say that the mere passage off the Fistelsekretion vets liverpool only temporarily repaired. After the shift back the fistula usually breaks up again. The chair derivation can improve the conditions for a local rehabilitation of the fistulous tract, so that you should not give up operational vets liverpool activities at the fistula after stoma. This is especially true for rectovaginal fistula affect the affected patients usually considerably.
Dr. med. Matthias Kemmer Ling, Surgery, Visceral Surgery and Proctology, formerly senior physician at the Department of Surgery II, Coloproctology, Raphael Hospital Muenster Dr. med. Franz Raulf, chief physician of Surgery, Coloproctology, Raphael Hospital Muenster.
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