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Incidence and management of anorectal abscess, fistula and fissure, in patients with ulcerative colitis
Summary and Conclusions
During a survey of 465 patients with ulcerative colitis, it was learned that 82 (17.6%) had one or more anorectal complications such as abscess, fistula-in-ano, rectovaginal fistula and fissure-in-ano. These complications were associated with attacks of colitis, which generally were severe.
The incidence of fissure-in-ano was significantly greater when colitis was extensive, but that of abscess and fistula varied little with the severity and extent of the disease.
All complications occurred most frequently during the year of the first attack; after this the duration of symptoms of colitis had little effect on the incidence of anorectal complications.
Treatment of each complication is discussed. Perianal abscess requires immediate incision and drainage. Six cases of spontaneous healing of fistula-in-ano are described. Rectovaginal fistula required excisional surgery. Fissure-in-ano was treated by symptomatic measures alone.
It is emphasized that treatment of these complications must be accompanied by vigorous treatment of ulcerative colitis itself.
Source:
/link.springer.com/article/10.1007/BF02616981