Surgery কমন একটি কেইস যা প্রায়ই OT করা হয় এমন কি ভাইভাতেও ধরে অনেক সময়।
Fistula তো আমরা জানি,দুইটা Opening থাকে তো অইটাই যখন এই Region এ হয় নাম হয় এইটা। অর্থাৎ
An anal fistula is an abnormal tract connecting the anal canal to the perianal skin, usually originating from a cryptoglandular infection that leads to a perianal abscess.
কাদের বেশি হয়? মূলত ছেলেদের হয় particularly between the ages of 30 to 50 years.
C/F কি হবে?
Perianal pain
Pus or blood discharge
Pruritus ani
Perianal swelling
Intermittent fever
কি কি ধরনের হইতে পারে?
Classification (Parks’ Classification):
According to Parks’ classification, anal fistulas are categorized into four types:
1. Intersphincteric (54%) – Confined within the internal sphincter.
2. Trans-sphincteric (44%) – Extends through both internal and external sphincters.
3. Suprasphincteric (2%) – Passes above the puborectalis muscle and opens into the ischiorectal fossa.
4. Extrasphincteric (1%) – Bypasses the sphincter mechanism entirely and opens into the skin.
কি কি টেস্ট করে রাখতে পারি?
Investigation:
MRI Fistulogram – Best modality to determine fistula tract anatomy.
Endoanal Ultrasound – Useful for complex fistulas.
Management কি হবে? Surgery কিন্তু বিভিন্ন ধরনের পদ্ধতি আছে। চলুন দেখে আসি
Common procedures গুলো হতে পারে
1. Fistulotomy – Most common, involves laying open the fistula tract.
2. Fistulectomy – Complete excision of the fistula tract.
3. Seton Placement – Used in high fistulas to allow gradual healing and sphincter preservation.
4. LIFT Procedure (Ligation of Intersphincteric Fistula Tract) – A sphincter-sparing technique.
5. Advancement Flap Repair – Used in recurrent or complex cases.
Postoperative Care & Complications খুবই গুরুত্বপূর্ণ
Wound care & hygiene
Pain management
Avoid constipation (high-fiber diet, stool softeners)
Recurrence & incontinence are major concerns, particularly with complex fistulas.
Raiyyan Tahsan Date:-4-03-2025 Tuesday Time:12-55-49 Pm
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