Tubercular fistula-in-ano | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2008]

Author(s):

1. Iram Bokhari: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

2. Syed Sagheer Hussain Shah: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

3. Inamullah: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

4. Zahid Mehmood: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

5. Syed Umer Ali: The Aga Khan University Hospital, Karachi, Pakistan.

6. Asadullah Khan: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

Abstract:

Objective: To determine the frequency of tuberculosis in recurrent fistula-in-ano. Study Design: Case series. Place and Duration of Study: This study was conducted in Surgical Ward-3, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from 1998 to 2007. Patients and Methods: The study included 100 cases of recurrent fistula-in-ano not responding to conventional surgery. Patients with other co-morbidities such as diabetes mellitus, bleeding disorders or with the evidence of pulmonary, abdominal or intestinal tuberculosis were excluded from this study. Fistulogram was performed in all patients. All the patients were subjected to fistulectomy followed by histopathology of the resected specimen. Thereafter, confirmation of the disease, anti-tuberculous treatment was immediately started and response to treatment was observed after 6 months. Results: Out of the 100 studied patients, 11 cases had biopsy proven tuberculosis in the fistula. All the patients were male. The fistulae were low type, single and usually located posteriorly (n=9) with everted margins. Ten were located within 3 cm of anus. Fistulogram revealed single internal opening. Comparative statistics of tuberculous fistula-in-ano with fistulas due to specific inflammation revealed no major differences. The diagnosed patients of tubercular fistulae-in-ano were observed for at least 6 months after starting anti-tuberculous treatment. They all responded well to anti-tubercular treatment and the fistulae healed without any complication such as recurrence or anal stenosis within 6 months. Conclusion: Tuberculosis should be suspected in case of recurrent fistulae-in-ano, so as to avoid unusual delay in the treatment and miseries to the patient. Appropriate anti-tuberculous therapy leads to healing within 6 months.

Page(s): 401-403

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 18, Issue: 7, Year: 2008

Keywords:

Recurrence , Tuberculosis , Fistulainano

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