Complex Fistula-in-Ano Extending From the Anal Canal to Mid-Thigh Treated With Combine Fistulectomy and Video-Assisted Anal Fistula Treatment (VAAFT): A Case Report

Complex Fistula-in-Ano Extending From the Anal Canal to Mid-Thigh Treated With Combine Fistulectomy and Video-Assisted Anal Fistula Treatment (VAAFT): A Case Report

An anal fistula is abnormal, chronic epithelial-lined communication between the anorectal lumen and the skin of the perineum or buttock. A complex fistula-in-ano is difficult to diagnose and treat; it requires careful approaches because of the high risk of complications and recurrences. We report a...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) Vol. 15; no. 12; p. e51373
Main Authors: Ullah, Zia, Sani, Usaal, Khan, Shahzeb, Mazher, Muhammad, Sarwar, Saeed
Format: Journal Article
Language:English
Published: United States Cureus Inc 31-12-2023
Cureus
Subjects:
Anus
Case reports
Crohns disease
Fistula
General Surgery
Public Health
Skin
Surgery
complex perianal fistulas
fistula in-ano
vaaft
fistulectomy
mri
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Summary:An anal fistula is abnormal, chronic epithelial-lined communication between the anorectal lumen and the skin of the perineum or buttock. A complex fistula-in-ano is difficult to diagnose and treat; it requires careful approaches because of the high risk of complications and recurrences. We report a case of a 60-year-old male who presented with a discharging sinus on the posteromedial aspect of his left thigh for the past two years. On examination, there were two external openings on the posteromedial aspect of the left thigh, 20 cm away from the anal verge, extending toward the left buttock, with an internal opening on the right side of the anal canal at 11 o'clock in the lithotomy position. The MRI showed a fluid-filled marginally enhancing tract ascending obliquely from the skin of the posterior left thigh, passing through the left gluteus maximus to the bilateral ischioanal fossae. The distal 7 cm tract was excised, as the rest of the tract was deep, passing through the gluteus maximus. Therefore, a video-assisted anal fistula treatment (VAAFT) procedure was done for the remaining tract. The wound was left open for healing by secondary intention. The patient was monitored for six months during which time the wound healed completely.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
content type line 23
ObjectType-Report-1
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.51373