1 / 15

DIFFICULT FISTULAE

DIFFICULT FISTULAE. BA Taylor North Cheshire M62 Coloproctology Course. AS (17.10.47). May ’04: L ischio-rectal abscess 27.7.04: Abdominal colic & altered bowel habit: RE; fistula at 3 o’clock 13.12.04: EUA; “high” trans- sphincteric fistula ext. opening 3 o’clock

dorothy-cross
Télécharger la présentation

DIFFICULT FISTULAE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. DIFFICULT FISTULAE BA Taylor North Cheshire M62 Coloproctology Course

  2. AS (17.10.47) • May ’04: L ischio-rectal abscess • 27.7.04: Abdominal colic & altered bowel habit: RE; fistula at 3 o’clock • 13.12.04: EUA; “high” trans- sphincteric fistula ext. opening 3 o’clock int. opening 6 o’clock

  3. AS (17.10.47)

  4. AS (17.10.47) • 13.12.04: EUA ext. sphincter skeletonized mucosa/int. sphincter divided tight (“cutting”) Seton • 4.1.05: well • 10.2.05: EUA; minimal residual division • 29.3.05: well

  5. KC (4.7.55) • 30.9.01: R ischio-rectal abscess • 1.11.01: Discharged (no fistula apparent) • 7.8.03: Recurrent R ischio-rectal abscess Drained; horseshoe (5-9 o’clock) No obvious fistula • 9.3.04: Healed; discharged Histology: non-specific

  6. KC (4.7.55) • 27.9.04: Recurrent R ischio-rectal abscess EUA; ? int. opening at 6 o’clock • 2.10.04: Further (posterior) collection • 9.11.04: Fully healed; offered EUA • 6.12.04: EUA; high complex supra-levator fistula. Int. opening at dentate; X2 ext. openings in scar. MR scan

  7. KC (4.7.55)

  8. KC (4.7.55)

  9. KC (4.7.55) • Jan ’05: EUA; external openings cored out Fistula track curetted Fibrin glue to track Overnight stay • March ’05: Healed (so far!)

  10. KH (21.12.84) • 19.2.03: Abdominal colectomy & ileostomy Severe CUC • 20.5.03: Adhesiolysis, proctectomy, double stapled J pouch-anal anastomosis • 4.6.03: EUA; tiny pouch-vaginal fistula • 5.6.03: laparotomy, adhesiolysis, stoma

  11. KH (21.12.84) • 16.9.03: EUA; no fistula • Oct ’03: pouchogram; no fistula • 11.11.03: EUA (air insufflation/ methylene blue); no fistula Pouchoscopy; normal • Jan ’04: Admission for ileostomy closure EUA; obvious pouch-vaginal fistula at anastomosis

  12. KH (21.12.84)

  13. KH (21.12.84) • 22.3.04: Mucosectomy, direct closure of fistula and pouch advancement Hand-sewn, endo-anal re- anastomosis. • June ’04: Pouchogram –ve • July ’04: EUA; ileostomy closure • Sept ’04: Well

  14. VB (29.8.75) • 6.10.04: 4th degree obstetric injury Levators mobilized & overlapped Perineal muscles closed Mucosa /skin closed • 28.2.05: Excellent bowel function/flatus PV • 15.3.05: EUA; small ano-vaginal fistula

  15. VB (29.8.75)

More Related