THE DIAGNOSTICS FEATURES OF FISTULAS IN ANORECTAL REGIONS

Z.F.BAKHSHALIYEV

Azerbaijan Medical University, Baku, AZERBAIJAN

Anorectal fistulas are quite widely spread among the population. According to statistical data of the recent years, fistulas occur in 5 of every thousand of able-bodied population. 90% of anal fistulas form after cryptoglandular abscesses, and the remaining 10% of fistulas are specific and the main role in the their appearance is played by tuberculosis (0,3-0,5%), actinomycosis (0,04 %), trauma (0,32%), Crohn's disease, pararectal and presacral pyocysts, malignant tumors of the rectum. Anorectal fistulas recur in 15-25% of cases after surgical operation and one of the main reasons of the problem is failure to form timely correct diagnosis and, as a result, implementation of inadequate surgical intervention. On the other hand, new examination method available at present, not only help but also create a number of problems. Thus, such examination method, are not available in all clinics, and sometimes are unnecessarily assigned to patients. This leads to both loss of time, and unnecessary economic expenses. It becomes clear from all the above-listed that anorectal fistulas are one of the spheres of surgery claiming attention and requiring investigations. The main purpose of the investigation is to improve the diagnostics of anorectal fistulas, select a correct surgical approach and as a result, increase the effectiveness of the treatment. The examination group included 73 patients that underwent inpatient treatment for chronic periproctitis in 2007-2010 at the Surgical Clinic of AzSATID named after A.Aliyev. Of them 62 were men, and 11 were women. In 9 of the patients that entered with chronic periproctitis diagnosis recurrent periproctitis (12.3%), in 10 – incomplete internal fistula (13.6% ) and in 3 horseshoe fistulas (4.1% ) were found out. During the examination both classic (visual examination, palpation, rectal palpation, anoscopy, vital paint, intubation, fistulography, bacteriologic and histologic investigations) and modern methods (computer tomography, nuclear magnetic resonance, rectal ultrasonography) were used. Traditional methods of examination (besides fistulography, bacteriologic and histologic examinations) were carried out in almost all the patients. Fistulography was carried out only in complex, recurrent fistulas (14 cases), and computer tomography, nuclear magnetic resonance, rectal ultrasonography in cases of suspicion of specific fistulas (6 cases).

The conducted investigations showed that classic methods of examination are often sufficient in topical diagnostics of anorectal fistulas. Modern methods of investigation are assigned in case of complex, recurrent andspecific fistulas of anorectal and sacrococcygeal region. Modern methods of examination shall be used not spontaneously, but systematically and purposefully.

Date: 2014-12-28; view: 1105