-
Clinical and Experimental Pediatrics Jul 2020
PubMed: 32252144
DOI: 10.3345/cep.2020.00150 -
Internal Medicine (Tokyo, Japan) Feb 2022Listeria monocytogenes can cause gastrointestinal infections in healthy children and adults, but they tend to be mild and self-limiting. It can, however, cause serious...
Listeria monocytogenes can cause gastrointestinal infections in healthy children and adults, but they tend to be mild and self-limiting. It can, however, cause serious potentially lethal infections, such as meningitis and bacteremia, to those with underlying conditions. A woman in her 60s with liver cirrhosis developed abdominal pain and a fever, and she turned out to have a perianal abscess caused by L. monocytogenes. Perianal abscess is a rare complication of L. monocytogenes, but a recent epidemiological study revealed that the presence of cirrhosis might also be a risk factor for the development of invasive disease.
Topics: Abscess; Adult; Bacteremia; Child; Female; Fever; Humans; Listeria monocytogenes; Listeriosis; Meningitis, Listeria
PubMed: 34393168
DOI: 10.2169/internalmedicine.7755-21 -
ANZ Journal of Surgery Jul 2022Perianal abscesses are a common surgical emergency. Due to their perceived ease, drainage is often delegated to junior trainees with varying levels of experience. The...
BACKGROUND
Perianal abscesses are a common surgical emergency. Due to their perceived ease, drainage is often delegated to junior trainees with varying levels of experience. The purpose of this study is to evaluate the current trend in perianal abscesses management at our institution, and identify factors that predict subsequent fistula formation or abscess recurrence.
METHODS
All acute patients admitted to a major teaching hospital who required surgical drainage of a perianal abscess were analysed over a two-year period from January 2019 to December 2020. Patient demographics, clinical and laboratory findings were retrospectively reviewed. Proceduralist experience, operative management strategy and recurrence rates (fistula or abscess) were analysed.
RESULTS
The mean age of patients was 43 years old, and 73% were male. Trainees performed 96% of the procedures. Re-presentation with a fistula or abscess recurrence requiring further surgery was 31%. Comorbidities of IBD, diabetes, or malignancy were present in one-third of patients and significantly increased the risk of recurrence (P = 0.01). Searching for a fistula tract was performed in 41% of cases but did not reduce recurrence (P = 0.9). Seton insertion occurred in 10%, and fistulotomy in 2%.
CONCLUSION
Perianal abscess drainage at our institution is almost exclusively performed by trainees, the majority of which occurs after-hours. Patients who present with a fever, inflammatory bowel disease, diabetes mellitus or malignancy are at an increased risk of recurrent abscess or a subsequent fistula after drainage, and input from an experienced surgeon may be of value when considering seton insertion or fistulotomy.
Topics: Abscess; Adult; Anus Diseases; Drainage; Female; Humans; Male; Rectal Fistula; Recurrence; Retrospective Studies; Skin Diseases; Treatment Outcome
PubMed: 35485429
DOI: 10.1111/ans.17750 -
Journal of the Korean Society of... May 2023Perianal fistula is a common inflammatory condition in the general population and affects the area around the anal canal. Although most cases are benign, they cause... (Review)
Review
Perianal fistula is a common inflammatory condition in the general population and affects the area around the anal canal. Although most cases are benign, they cause serious morbidity and require surgical treatment due to a high risk of recurrence. MR imaging is a gold standard technique for the evaluation of perianal fistulas and provides accurate information on the anatomy of the anal canal, its relationship to the anal sphincter complex, accurate identification of secondary tracts or abscesses, and reporting associated complications. MR imaging can help monitor treatment effects and determine treatment methods. Crohn's disease-related fistulas often require medical rather than surgical treatment. The radiologist is required to know the anatomy and MR imaging findings of the perianal fistula to present an accurate diagnosis to the clinician.
PubMed: 37325009
DOI: 10.3348/jksr.2023.0018 -
Frontiers in Surgery 2022
PubMed: 35836609
DOI: 10.3389/fsurg.2022.952874 -
Annals of Gastroenterology 2017Patients with Crohn's disease often develop perianal disease, successfully managed in most cases. However, its most aggressive form, complex perianal disease, is... (Review)
Review
Patients with Crohn's disease often develop perianal disease, successfully managed in most cases. However, its most aggressive form, complex perianal disease, is associated with high morbidity and a significant impairment in patients' quality of life. The aim of this review is to provide an updated approach to this condition, reviewing aspects of its epidemiology, diagnosis and therapeutic alternatives. Emerging treatment options are also discussed. A multidisciplinary assessment of these patients with a coordinated medical and surgical approach is crucial.
PubMed: 28042236
DOI: 10.20524/aog.2016.0099 -
Clinics in Colon and Rectal Surgery Mar 2018Anorectal complaints are not uncommon in pediatric care, but the etiology and management can differ significantly from adults. Age is an important factor when... (Review)
Review
Anorectal complaints are not uncommon in pediatric care, but the etiology and management can differ significantly from adults. Age is an important factor when considering etiology and management, distinguishing between infants, children, and adolescents. For all ages, malignancy is rarely a consideration, but a thorough examination of infants and children typically requires deep sedation or general anesthesia. Very little primary literature or evidence exists to guide care; so there are many opportunities for careful study to enhance our understanding beyond personal experience and historical practice patterns.
PubMed: 29487494
DOI: 10.1055/s-0037-1609026 -
Ugeskrift For Laeger Dec 2020Anal abscesses are well-known conditions worldwide. The golden standard of acute treatment is incision and drainage. Knowledge of the anatomy of the anal area and the... (Review)
Review
Anal abscesses are well-known conditions worldwide. The golden standard of acute treatment is incision and drainage. Knowledge of the anatomy of the anal area and the abscess involvement of perianal spaces is crucial in order to perform safe and correct surgical treatment as summarised in this review. Pre- and perioperative imaging with magnetic resonance imaging, endoanal ultrasonography or CT facilitates correct incision and drainage, while antibiotics as conservative approach have no place in the treatment of abscesses. One third of the patients have an underlying fistula, and if suspected referral to a fistula centre is warranted.
Topics: Abscess; Anal Canal; Anus Diseases; Drainage; Humans; Rectal Fistula
PubMed: 33317691
DOI: No ID Found -
The Indian Journal of Surgery Dec 2015Management of benign anorectal conditions like abscesses and haemorrhoids is usually uneventful. However, complicated perianal complications can result and have sparsely...
Management of benign anorectal conditions like abscesses and haemorrhoids is usually uneventful. However, complicated perianal complications can result and have sparsely been reported in literature. Hereby, we report a series of seven patients who presented with rare sequelae like necrotising fasciitis, intraperitoneal or retroperitoneal involvement. All patients responded well to surgical management. Accordingly, complicated perianal sepsis warrants a timely and aggressive surgical intervention.
PubMed: 27011454
DOI: 10.1007/s12262-013-0997-y -
The Israel Medical Association Journal... Mar 2007Perianal Crohn's disease refers to the involvement of the anal region in this chronic inflammatory bowel disease. It most commonly presents with the formation of... (Review)
Review
Perianal Crohn's disease refers to the involvement of the anal region in this chronic inflammatory bowel disease. It most commonly presents with the formation of perianal abscesses and fistulas, although other forms of presentations such as fissures and skin tags may also be present. Perianal activity often parallels abdominal disease activity, but may occasionally be the primary site of active disease, and significantly compromises the quality of life in affected patients. The primary treatment of patients with perianal Crohn's disease combines medical and surgical management with the aim of improving quality of life and alleviating suffering. A multidisciplinary approach involving the patient, surgeon, gastroenterologist, radiologist, pathologist, nutritionist, and other specialists makes the successful treatment of PCD possible. This paper reviews the management of patients with perianal Crohn's disease, focusing on contemporary medical and surgical treatments such as infliximab, endorectal advancement flap, instillation of fibrin glue, and the potential use of extracellular matrix plugs.
Topics: Anus Diseases; Combined Modality Therapy; Crohn Disease; Diagnostic Imaging; Humans
PubMed: 17402327
DOI: No ID Found