الفهرس 
Anatomy of the Anal CanalOnly 14 pages are availabe for public view
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Abstract
New Trends in Management of Perianal Fistula .Disease
ABSTRACT
Professor Dr. Osama Ali El Atrash, Dr. Ehab Hussein Abd El Wahab; Ahmed Mohammed Shaaban
Faculty of Medicine – Ain Shams University
Introduction:
Anal fistulas are the main aetiology of perianal abscesses and suppurations. They are common and generally associated with pain, faecal incontinence, impaired quality of life and work incapacity. The therapeutic management involved has a twofold objective: heal suppuration and preserve sphincter function. In about 80% of cases, anal fistulas are secondary to an infection of the anal glands (cryptogenic or cryptoglandular). This anal gland infection can lead to an abscess between the internal and external sphincters, which can also spread to other parts of the perianal region. The infection can follow many directions from this point in the intersphincteric space. The fistula is formed when the pus reaches the skin. The origin of anal fistulas is therefore always intraductal, cryptic, with a primary port at this level and usually a secondary port in the skin. Although the classification of anal fistulas is still under debate, they are usually divided into two groups. Aim of the Work. The aim of this work is to review the new methods in diagnosis and treatment of perianal fistula disease. Summary A fistula-in-ano is an abnormal tract or cavity communicating with the rectum or anal canal by an identifiable internal opening. It is characterized by chronic purulent drainage or cyclical pain associated with abscess formation. Widely accepted cryptoglandular theory leading to abscess formation and fistula development needs to be well understood as this is the pathology responsible for almost 90% of the perineal sepsis and anal fistulas. Although the most common etiology for perianal fistula is an anorectal abscess, other etiologies include crohn’s disease, hidradenitis suppurativa, trauma, prior anal surgery, infections (such as HIV, tuberculosis, or actinomycosis), and malignancy. The complications after anal fistula surgery can be divided into early and late. Early complications that develop most frequently include postoperative bleeding, infectious complications and urine retention.
Key words: AES Anal endosonography; AF: Anal fistulae; AFP: Anal fistula plug; ASCs: Adipose-derived stem cells; CT: Computed tomography; EAS; External anal sphincter; EAUS: Endoanal ultrasound.