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. 2015 Jan;20(1):22-5.

How the anal gland orifice could be found in anal abscess operations

Shahram Paydar  1 , Ahmad Izadpanah  1 , Leila Ghahramani  1 , Seyed Vahid Hosseini  1 , Alimohammad Bananzadeh  1 , Salar Rahimikazerooni  1 , Faranak Bahrami  2
Affiliations
Free PMC article

How the anal gland orifice could be found in anal abscess operations

Shahram Paydar et al. J Res Med Sci. 2015 Jan.
Free PMC article

Abstract

Background: On an average 30-50% of patients who undergo incision and drainage (I and D) of anal abscess will develop recurrence or fistula formation. It is claimed that finding the internal orifice of anal abscess to distract the corresponding anal gland duct; will decline the rate of future anal fistula. Surgeons supporting I and D alone claim that finding the internal opening is hazardous. This study is conducted to assess short-term results of optional method to manage patients with anal abscess and fitula-in-ano at the same time.

Materials and methods: In this cross-sectional descriptive study 49 from 77 patients with anal abscess whose internal orifice was not identified by pressing on the abscess, diluted hydrogen peroxide (2%) and methylene blue was injected into the abscess cavity and the anal canal was inspected to find out the internal opening. Once the opening was distinguished, an incision was given from the anal verge to the internal opening.

Results: The internal orifice was identified in 44 out of 49 patients (90%) who underwent this new technique. Up to 18 months during follow-up, only 2.5% of patients with primary fistulotomy developed fistula on the site of a previous abscess.

Conclusion: Conventional method to seek the internal orifice of anal abscesses is successful in about one-third of cases. By applying this new technique, surgeons would properly find the internal opening in >90% of patients. Needless to say, safe identification of the anal gland orifice in anal abscess disease best helps surgeons to do primary fistulotomy and in turn it would significantly decrease the rate of recurrence in anal abscess and fistula formation.

Keywords: Abscess; anal fistula; anal gland; colorectal surgery; drainage.

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Conflict of interest statement

Conflict of Interest: No conflict of interests.

Figures

Figure 1
Figure 1
Superficial preanal abscess
Figure 2
Figure 2
Finding of internal orifice
Figure 3
Figure 3
Probing throughout the orifice
Figure 4
Figure 4
Laying open the abscess cavity
Figure 5
Figure 5
Number of patients in different groups of study
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