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    Anal Abscess And Fistula, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Anal Abscess And Fistula, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Anal Abscess And Fistula, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Ebook118 pages56 minutes

    Anal Abscess And Fistula, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    An anal abscess is an infected cavity filled with pus found near the anus or rectum.
    Ninety percent of abscesses are the result of an acute infection in the internal glands of the anus.
    Occasionally, bacteria, fecal material or foreign matter can clog an anal gland and tunnel into the tissue around the anus or rectum, where it may then collect in a cavity called an abscess.
    An anal fistula (fistula-in-ano) is often the effect of a previous or present anal abscess.
    This occurs in up to 50% of patients with abscesses.
    The fistula is the tunnel that forms under the skin and connects the clogged infected glands to an abscess.
    The anal fistula can be present with or without an abscess and may join just to the skin of the buttocks near the anal opening.
    Classification of Anal Abscess
    1. Superficial abscesses (subcutaneous, sub-mucosal, ischiorectal abscesses) show typical symptoms such as pain, swelling, tenderness and fever.
    Due to their anatomic location, they often cause discomfort on walking and sitting.
    Normally the surrounding area to the anal canal induces painful defecation
    2. Deep abscesses (inter-muscular, pelvi-rectal) often lack typical symptoms
    Types of Anal Fistula
    Fistulas are classified by their relationship to parts of the anal sphincter complex (the muscles that allow people to control the stools).
    They are classified as:
    Inter-sphincteric,
    Trans-sphincteric,
    Supra-sphincteric and
    Extra-sphincteric
    Causes of Anal Abscess:
    Both aerobic and anaerobic bacteria have been found to be responsible for abscess formation.
    The aerobes most often implicated are Staphylococcus aureus, Streptococcus, and Escherichia coli.
    The anaerobes most often implicated are Bacteroides fragilis, Peptostreptococcus, Prevotella, Fusobacterium, Porphyromonas, and Clostridium.
    Causes of Anal fistula
    Most anal fistulas begin in anal glands that become infected with resulting abscess formation.
    When the abscess is opened or when it bursts, a fistula is formed.
    Fistulas are also found in patients with inflammatory bowel disease especially Crohn disease.
    The most frequent symptoms of an abscess are:
    1. Anorectal pain,
    2. Anal swelling,
    3. Peri-anal cellulitis (redness of the skin) and
    4. Fever
    A patient with an anal fistula may complain of:
    1. Recurrent malodorous drainage from the peri-anal skin,
    2. Pruritus and irritation of the peri-anal skin,
    3. Recurrent abscesses,
    4. Fever
    5. Rectal bleeding
    Diagnosis:
    Many anal abscesses and fistulas are diagnosed and treated on the source of medical findings.
    Both traditional 2-dimensional and 3-dimensional endo-anal ultrasound are a very effective way of:
    1. Diagnosing a deep peri-rectal abscess,
    2. Identifying a horseshoe extension of the abscess
    Occasionally endosonography of fistula, if required with contrast medium, and recently MRI have been useful to find the best treatment method.
    Treatment:
    Abscesses
    The treatment of an abscess is surgical incision and drainage under most situations.
    An incision is made in the skin near the anus to drain the infection.
    This can be done in a doctor’s clinic with local anesthetic or in a surgical theater under general anesthesia.
    Anal Fistula
    Presently, there is no medical treatment available for this disorder and surgery is almost always necessary to cure an anal fistula.
    If the fistula is straightforward (affecting minimal sphincter muscle), a fistulotomy may be done.
    This surgery involves un-roofing the tract, thereby connecting the internal opening within the anal canal to the external opening and producing a groove that will heal from the inside out.
    Fistulotomy
    Fibrin glue
    Bioprosthetic plug
    Advancement flap procedure
    LIFT Surgery

    TABLE OF CONTENT
    Introduction
    Chapter 1 Anal Abscess and Fistula
    Chapter 2 Causes
    C

    LanguageEnglish
    PublisherKenneth Kee
    Release dateAug 22, 2017
    ISBN9781370754342
    Anal Abscess And Fistula, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Anal Abscess And Fistula, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee

      Anal Abscess

      And Fistula,

      A

      Simple

      Guide

      To

      The Condition,

      Diagnosis,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2017 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes Anal Abscess and Fistula, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

      (What The patient Need to Treat Anal Abscess and Fistula)

      This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

      My purpose in writing these simple guides was for the health education of my patients.

      Health Education was also my dissertation for my Ph.D (Healthcare Administration).

      I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

      This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

      From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.

      Some people have complained that the simple guides are too simple.

      For their information they are made simple in order to educate the patients.

      The later books go into more details of medical disorders.

      The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

      Since 2013, I have tried to improve my spelling and writing.

      As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

      Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

      I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

      I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

      I apologize if these repetitions are irritating to some readers.

      Chapter 1

      Anal Abscess and Fistula

      What is Anal Abscess?

      An anal abscess is an infected cavity filled with pus found near the anus or rectum.

      Ninety percent of abscesses are the result of an acute infection in the internal glands of the anus.

      Occasionally, bacteria, fecal material or foreign matter can clog an anal gland and tunnel into the tissue around the anus or rectum, where it may then collect in a cavity called an abscess.

      What is Anal Fistula?

      An anal fistula (fistula-in-ano) is often the effect of a previous or present anal abscess.

      This occurs in up to 50% of patients with abscesses.

      Normal anatomy includes small glands just inside the anus.

      The fistula is the tunnel that forms under the skin and connects the clogged infected glands to an abscess.

      The anal fistula can be present with or without an abscess and may join just to the skin of the buttocks near the anal opening.

      Classification of Anal Abscess

      1. Superficial abscesses (subcutaneous, sub-mucosal, ischiorectal abscesses) show typical symptoms such as pain, swelling, tenderness and fever.

      Due to their anatomic location, they often cause discomfort on walking and sitting.

      Normally the surrounding area to the anal canal induces painful defecation

      2. Deep abscesses (inter-muscular, pelvi-rectal) often lack typical symptoms.

      Diffuse pelvic pain and raised body temperature are found occasionally.

      Besides physical examination have proven to give information about deeper abscesses including:

      a. Rectal-digital examination,

      b. CT,

      c. MRI

      d. Endosonography

      Anal abscesses are categorized by their location in relation to the structures composing and enclosing the anus and rectum: peri-anal, ischio-anal, inter-sphincteric and supra-levator.

      The peri-anal area is the most frequent and the supra-levator the least.

      If any of these special forms of abscess extends partially circumferentially around the anus or the rectum, it is called a horseshoe abscess.

      Fistulas are classified by their relationship to parts of the anal sphincter complex (the muscles that allow people to control the stools).

      They are classified as inter-sphincteric, trans-sphincteric, supra-sphincteric and extra-sphincteric.

      The inter-sphincteric is the most frequent and the extra-sphincteric is the least common.

      These classifications are important in helping the surgeon make treatment decisions.

      An anal fistula is an inflammatory tract between the anal canal and the skin.

      The 4 categories of fistulas, based on

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