Perianal Fistula

What is a perianal abscess?

A perianal abscess is a collection of pus in a cavity that is formed in the area around the anus, as a result of microbial infection and inflammation of the dentate line of the recto-anus and by extension the perianal area.


What are the symptoms of perianal abscess?

Severe pain in the anus area, sensitivity upon touching and fever.


What are the causes of perianal abscess?

An abscess, like a fistula, is due to infection and inflammation that has occurred in some internal opening. It can also be due to hidradenitis, Crohn’s disease or injury.


How is perianal abscess treated?

The treatment of perianal abscess is surgical and involves the rapid opening and extensive drainage of the purulent fluid by the shortest route.

The operation is preferably performed in the operating room. The patient is sedated or anesthetized with a laryngeal mask.

The incision should be such as to allow extensive drainage of the abscess contents, but without injuring the sphincter muscles of the anus.

After drainage, the wound is cleaned with antiseptic solutions and the wound is allowed to heal by secondary intention. Daily changes and surgical cleaning of the wound are necessary.

Patient’s relief after surgery is impressive.


Perianal fistula

What is an anal fistula?

A perianal fistula is a small tunnel that connects the inside of the intestine/lumen (internal orifice) and an opening in the skin (external orifice).


How are anal fistulas formed?

In cases of untimely and unsuitable treatment of a perianal abscess, or in cases of chronic abscess formation, there is an increased risk of fistula formation.


What are the symptoms of an anal fistula?

Typically, patients complain of soiling their underwear, without being incontinent. The reason is that there is a discharge of pus from the external opening of the fistula. Secondarily, itching in the area and perianal skin irritation from the continuous discharge of pus can be observed.


What causes an anal fistula?

Most anal fistulas have the same pathogenesis as abscesses. That is, they are caused by the blockage of the pores in the area, inevitably leading to an infection.


What is the treatment for anal fistulas?

Fistulas can be treated surgically. Treatment aims at sealing this abnormal channel of communication between the skin and the inside of the intestine, without injuring the sphincter muscles of the anus.

Laser technology has brought a revolution in the treatment of fistulas. The FiLac technique began to be applied with great success in Germany a few years ago, and we are among the first to bring this revolutionary treatment to Greece.

It is important to know that recurrence of perianal abscess occurs at a rate of 10%, while half of the cases of abscess results in the formation of a perianal fistula.


How do I choose the right treatment?

The surgeon recommends the right treatment for each patient based on experience and taking into account several parameters with regards to the patient’s overall health and profile. The doctor decides postoperatively whether to administer an antibiotic.