Perianal Fistula Operated with Local Anesthesia

Abstract

Introduction: Anorectal fistulas are a chronic process due to the presence of abscesses and consist of abnormal communication between the anus-rectum and adjacent structures or a neighboring organ through a pathway; therefore, the therapeutic management of these fistulas has crucial importance.

Objective: To expand theoretical and practical knowledge on the diagnosis and treatment of complicated anorectal fistula.

Case presentation: The case is presented of a 46-year-old adult with a diagnosis of chronic suppurative fistula in the perianal region that invaded the external genitalia. After preoperative checkup, ambulatory surgical intervention was performed with infiltrative local anesthesia, including follow-up twice a week in consultation during the first month and then weekly until his cure, and definitive discharge nine weeks after surgery.

Conclusions: Fistulotomy or opening of the fistulous tract is indicated in simple fistulas involving less than one third of the anal sphincter and in patients with normal sphincter function. These are the cause of incontinence more frequently in women and in patients with sphincter dysfunction and a history of perianal surgery or complex fistulas.