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Monday, September 14, 2015

Can we call a Tract from Anus without External Opening as Fistula-in-Ano?

Posted by Dr Prahallad Panda on 7:48 PM Comments



Fistula-in-Ano is a completely or incompletely epithelised tract that connects the internal opening in anus to an external opening in the perianal skin.
In most of the cases, external opening can be identified; whereas in minority of cases, external opining is absent.
It happens that a firm to hard tract is palpable, ending blindly in the perineum. This is a situation, when the perineal abscess has not broken the skin, though pus can be seen coming from anal opening, on pressing from the exterior.
Hence, whether the condition can be called as Fistula-in-ano, in true sense of the term?
English: Cassia-fistula
English: Cassia-fistula (Photo credit: Wikipedia)
In one case, a cystic swelling was noted in the posterior aspect of the scrotum, not attached to the testis; attached to it is a firm to hard tract that leads to the anal canal. A raw area can be felt in the superficial plane, in the anal canal; presumed to the internal opening of the tract. The tract could be probed.
The tract was dissected from near the base of the scrotum till the anal canal is reached, it is probed from inside and excision was completed.
The biopsy report of the tract comes as “Non-specific Chronic Inflammation.” No malignancy or Tuberculosis is seen.
Should we call it, “Anal-perineal Sinus” or “Anal-perineal blind Tract.”


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