Fistula-in-Ano complicated by Fournier′s gangrene our experience in North-Eastern region of Nigeria
Background: Fistula-in-ano when complicated by Fournier′s gangrene is an unusual finding and always carries high morbidity. This study details our experience in managing 10 cases. Methods of Study: Case files of all patients managed in University of Maiduguri Teaching Hospital and Federal Medical Ce...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Nigerian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2013;volume=19;issue=2;spage=56;epage=60;aulast=Bakari |
| _version_ | 1819069773746536448 |
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| author | Abubakar A Bakari Nuhu Ali Ibrahim A Gadam Bata M Gali Chubado Tahir KDT Yawe Adamu B Dahiru Baba S Mohammed Dauda Wadinga |
| author_facet | Abubakar A Bakari Nuhu Ali Ibrahim A Gadam Bata M Gali Chubado Tahir KDT Yawe Adamu B Dahiru Baba S Mohammed Dauda Wadinga |
| author_sort | Abubakar A Bakari |
| collection | DOAJ |
| description | Background: Fistula-in-ano when complicated by Fournier′s gangrene is an unusual finding and always carries high morbidity. This study details our experience in managing 10 cases. Methods of Study: Case files of all patients managed in University of Maiduguri Teaching Hospital and Federal Medical Center of Yola and Gombe from January, 2007 to December, 2011 were retrieved from Medical Record Departments and other Hospital Records. These were analyzed for demographic, clinical and pathological variables, the type of treatment and follow-up. Results: A total of 10 men with a mean age of 50.5 years (35-60) were managed in the period of study. Nearly, 50% of the patients were farmers, 30% businessmen and 20% were civil servant. 7 (70%) of these patients presented with Fournier′s gangrene within 4 weeks of development of fistula-in-ano and the rest within 8 weeks. 4 (40%) of these patients had inadequate drainage of their perianal abscess and 2 (20%) had incision and drainage. Another 4 (40%) had spontaneously rupture of the perianal abscess. 6 (60%) of the fistula-in-ano was submuscular, 30% subcutaneous and 10% were complex or recurrent. Nearly, 20% of patients had fistulotomy and seton application for adequate drainage. Mucosal advancement flap was performed in 5 (50%) and fistulotomy in 3 (30%) patients. Another 30% had fistulotomy and continuing sitz bath. Conclusion: Cryptoglandular infection is an important cause of perianal abscesses and fistula-in-ano and if poorly managed results in Fournier′s gangrene. Early broad spectrum parenteral antibiotic therapy and primary surgical treatment can prevent Fournier′s gangrene. |
| first_indexed | 2024-12-21T16:55:22Z |
| format | Article |
| id | doaj.art-b262e1f8263843919b18c337e9417435 |
| institution | Directory Open Access Journal |
| issn | 1117-6806 2278-7100 |
| language | English |
| last_indexed | 2024-12-21T16:55:22Z |
| publishDate | 2013-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Nigerian Journal of Surgery |
| spelling | doaj.art-b262e1f8263843919b18c337e94174352022-12-21T18:56:46ZengWolters Kluwer Medknow PublicationsNigerian Journal of Surgery1117-68062278-71002013-01-01192566010.4103/1117-6806.119237Fistula-in-Ano complicated by Fournier′s gangrene our experience in North-Eastern region of NigeriaAbubakar A BakariNuhu AliIbrahim A GadamBata M GaliChubado TahirKDT YaweAdamu B DahiruBaba S MohammedDauda WadingaBackground: Fistula-in-ano when complicated by Fournier′s gangrene is an unusual finding and always carries high morbidity. This study details our experience in managing 10 cases. Methods of Study: Case files of all patients managed in University of Maiduguri Teaching Hospital and Federal Medical Center of Yola and Gombe from January, 2007 to December, 2011 were retrieved from Medical Record Departments and other Hospital Records. These were analyzed for demographic, clinical and pathological variables, the type of treatment and follow-up. Results: A total of 10 men with a mean age of 50.5 years (35-60) were managed in the period of study. Nearly, 50% of the patients were farmers, 30% businessmen and 20% were civil servant. 7 (70%) of these patients presented with Fournier′s gangrene within 4 weeks of development of fistula-in-ano and the rest within 8 weeks. 4 (40%) of these patients had inadequate drainage of their perianal abscess and 2 (20%) had incision and drainage. Another 4 (40%) had spontaneously rupture of the perianal abscess. 6 (60%) of the fistula-in-ano was submuscular, 30% subcutaneous and 10% were complex or recurrent. Nearly, 20% of patients had fistulotomy and seton application for adequate drainage. Mucosal advancement flap was performed in 5 (50%) and fistulotomy in 3 (30%) patients. Another 30% had fistulotomy and continuing sitz bath. Conclusion: Cryptoglandular infection is an important cause of perianal abscesses and fistula-in-ano and if poorly managed results in Fournier′s gangrene. Early broad spectrum parenteral antibiotic therapy and primary surgical treatment can prevent Fournier′s gangrene.http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2013;volume=19;issue=2;spage=56;epage=60;aulast=BakariFistula-in-anoFournier′s gangreneperianal abscess |
| spellingShingle | Abubakar A Bakari Nuhu Ali Ibrahim A Gadam Bata M Gali Chubado Tahir KDT Yawe Adamu B Dahiru Baba S Mohammed Dauda Wadinga Fistula-in-Ano complicated by Fournier′s gangrene our experience in North-Eastern region of Nigeria Nigerian Journal of Surgery Fistula-in-ano Fournier′s gangrene perianal abscess |
| title | Fistula-in-Ano complicated by Fournier′s gangrene our experience in North-Eastern region of Nigeria |
| title_full | Fistula-in-Ano complicated by Fournier′s gangrene our experience in North-Eastern region of Nigeria |
| title_fullStr | Fistula-in-Ano complicated by Fournier′s gangrene our experience in North-Eastern region of Nigeria |
| title_full_unstemmed | Fistula-in-Ano complicated by Fournier′s gangrene our experience in North-Eastern region of Nigeria |
| title_short | Fistula-in-Ano complicated by Fournier′s gangrene our experience in North-Eastern region of Nigeria |
| title_sort | fistula in ano complicated by fournier s gangrene our experience in north eastern region of nigeria |
| topic | Fistula-in-ano Fournier′s gangrene perianal abscess |
| url | http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2013;volume=19;issue=2;spage=56;epage=60;aulast=Bakari |
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