Fistula caused by the abscess cranially, and then embraces the Puborektalisschlinge. Preoperatively

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Often the Fistelgeschehen manifested by the appearance of an abscess. The symptoms strongly depends here on the localization vets in edinburgh of the inflammatory process. Superficial perianal abscesses and lower anal canal can first draw attention to themselves by severe pain and increasing swelling. Occasionally, it then comes to a spontaneous bursting of the abscess with discharge of pus. The higher in the anal canal, above the pelvic floor muscles and deep in the fatty tissues of the Ischiorektalraums abscesses can go unnoticed and cause such significant diagnostic and therapeutic difficulties. Often they solve common inflammatory disease reactions with fever and generalized inflammation.
In contrast to the pain symptoms, for example, in the fissure Abszessgeschehen rarely shows a recurrent character over longer periods. The general symptoms cause the patient rather vets in edinburgh early medical treatment. Occasionally, the limiting processes of defense against infection are so effective that a subjectively little stressful, chronic stage of fistula formation occurs without abscess formation that makes desirable no further therapy for the patient.
Applies to all fistulas that the height of the muscle piercing Ganges is crucial for surgical therapy. The uncomplicated, typical intersphinktäre or transsphinktäre fistula has its muscle piercing transition usually. In the plane of the dentate line, the transition from anoderm the anal canal for grinding toll of the rectum or distal to this location The suprasphinktäre
Fistula caused by the abscess cranially, and then embraces the Puborektalisschlinge. Preoperatively should be clarity about the level localization of muscle piercing Ganges, because the extent of muscle transection is crucial vets in edinburgh for the occurrence of postoperative continence disorders. The dissection of the entire anal muscles including the Puborektalisschlinge is regular way connected with a complete incontinence. Overall, about 95 percent of a intersphincteric fistulas or transsphinktärischen course, with an elevation of muscle vets in edinburgh piercing Ganges vets in edinburgh not above the Dentatalinie so that they can be resolved without continence hazard. The suprasphinktärischen fistulas often caused by an incorrect exposure of the preceding abscess with a corresponding manipulation in Abszessraum.
Dr. med. Matthias Kemmer Ling, Surgery, Visceral Surgery and Proctology, formerly senior physician at the Department of Surgery II, Coloproctology, Raphael vets in edinburgh Hospital Muenster Dr. med. Franz Raulf, chief physician of Surgery, Coloproctology, Raphael Hospital Muenster.
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