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364607

Management of isolated deep postanal space suppuration via posterior sphincterotomy

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Last updated: 05 Jan 2025

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Abstract

Aim
The aim of this study was to evaluate the treatment of isolated deep postanal space (DPS) suppuration, using the posterior midline approach in terms of recurrence and post-drainage fistula formation.
Patients and methods
The study included 16 patients (13 men and three women) with isolated DPS suppuration without clinical or radiological evidence of extension. DPS affection was demonstrated by bidigital examination and preoperative MRI. All patients were managed by the posterior sphincterotomy approach performed by senior colorectal surgeons.
Results
Patients complained for a mean period of 23.75±19.43 days before seeking medical advice. There was great variability between duration in patients complaining of acute pain only (6.80±2.28 days) and chronic discharge only (31.40±14.09 days). Recurrence was encountered in two (12.5%) patients in the form of recurrent abscess (6.25%) that developed 3 months after the first drainage and anal fistula (6.25%) that developed 4 months postoperatively. Patients in the study reported satisfactory results with regard to postoperative continence after 3 months. These results showed further improvement at 6 and 12 months.
Conclusion
Isolated DPS suppuration should be managed with a senior colorectal surgeon. Without awareness of the problem and a clear understanding of anatomy, it is impossible to achieve successful treatment of the isolated DPS suppuration. Management of isolated DPS by the posterior sphincterotomy approach seems to be a successful technique with low recurrence rate and satisfactory postoperative continence status.

DOI

10.4103/ejs.ejs_16_20

Keywords

deep post anal space, perianal suppuration, posterior sphincterotomy

Authors

First Name

Walid M.

Last Name

Abd El Maksoud

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Orcid

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First Name

Mohamed Mazloum

Last Name

Zakareya

MiddleName

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Affiliation

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Orcid

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First Name

Ahmed D.

Last Name

Mohii

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Affiliation

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Volume

39

Article Issue

3

Related Issue

48961

Issue Date

2020-08-01

Receive Date

2020-01-16

Publish Date

2020-08-28

Print ISSN

1110-1121

Online ISSN

1687-7624

Link

https://ejsur.journals.ekb.eg/article_364607.html

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https://ejsur.journals.ekb.eg/service?article_code=364607

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364,607

Publication Type

Journal

Publication Title

The Egyptian Journal of Surgery

Publication Link

https://ejsur.journals.ekb.eg/

MainTitle

Management of isolated deep postanal space suppuration via posterior sphincterotomy

Details

Type

Article

Created At

21 Dec 2024