CONSTANT OR THROBBING PAIN
Pain that worsens while sitting or moving may indicate an active abscess.
العودة إلى الخدماتINFECTION CONTROL · MAPPING · CONTINENCE PRESERVATION
الخراج حول الشرج والناسور الشرجي
A perianal abscess is usually the acute infection, while an anal fistula is an abnormal tract that may persist or recur after drainage. An abscess usually requires timely drainage; fistula treatment is planned according to the tract and its relationship with the sphincters. Assessment is available in Athens for patients from Attica and throughout Greece.
PROMPT DRAINAGE WHEN NEEDEDSELECTIVE MRI / ULTRASOUNDSPHINCTER-PRESERVING PLAN
استكشف العملياتملاحظة: يتوفر التنقل داخل الصفحة بالعربية، بينما يُعرض المحتوى الطبي التفصيلي في هذه الصفحة التخصصية حالياً باللغة الإنجليزية.
ELIXIS · ADVANCED CARE
Abscess or fistula? The distinction changes treatment
Diagnosis is based on history and clinical examination. Pelvic MRI or endoanal ultrasound is not required for every simple case, but may be particularly useful for deep, complex or recurrent fistulas, after previous surgery or in Crohn's disease. In selected cases, the anatomy is confirmed by examination under anaesthesia.
الأعراض
Symptoms that merit assessment
A perianal abscess is an acute collection of pus near the anus and usually requires prompt drainage. An anal fistula is a tract connecting the anal canal to the skin and often follows an abscess, causing recurrent swelling or discharge.
PAINFUL SWELLING
A tender lump, redness and warmth around the anus require prompt assessment.
FEVER OR CHILLS
Fever, chills or significant systemic illness may accompany a deeper or progressing infection.
PURULENT DISCHARGE
Pus, blood or foul-smelling fluid from a small opening near the anus is a common fistula symptom.
SWELLING–DRAINAGE CYCLE
Episodes in which swelling improves after drainage and later returns are characteristic.
SKIN IRRITATION
Persistent moisture and discharge may cause itching, burning or skin irritation.
Spontaneous drainage may reduce pain but does not confirm that the infection has resolved. Recurrent, multiple or complex fistulas, particularly with diarrhoea, weight loss or abdominal symptoms, require assessment for Crohn's disease or another underlying cause.
العمليات
Treatment according to anatomy and disease phase
An acute abscess is treated first as an infection. There is no single fistula procedure suitable for everyone: the safest option depends on tract height, branches, sphincter involvement, previous operations and baseline continence.
01DRAINAGE
INCISION & DRAINAGE OF A PERIANAL ABSCESS
The main treatment for a formed collection of pus is timely surgical drainage.
- متى تُبحث
- Throbbing pain, tender swelling or a deeper abscess confirmed clinically or on imaging.
- ماذا تتضمن
- The collection is opened and adequately drained. Antibiotics do not replace drainage and are used selectively, such as for extensive cellulitis, systemic infection or immunosuppression.
02MAPPING
FISTULA MAPPING
The tract and its relationship with the sphincters determine which procedure is safe.
- متى تُبحث
- Recurrent or complex fistula, multiple branches, previous surgery, a deep abscess or suspected Crohn's disease.
- ماذا تتضمن
- Clinical examination is combined, when it will affect planning, with pelvic MRI or endoanal ultrasound. Imaging is selective rather than routine for every simple case.
03FISTULOTOMY
FISTULOTOMY
The tract is laid open so it can heal from the base to the surface.
- متى تُبحث
- Simple low fistulas crossing a small amount of sphincter, with an acceptable functional risk.
- ماذا تتضمن
- Anatomy is confirmed before division. Fistulotomy is unsuitable when the amount of muscle division required could materially affect continence.
04SETON
DRAINING SETON & STAGED TREATMENT
A loose seton keeps the tract open, permits drainage and controls infection without intentional sphincter division.
- متى تُبحث
- Complex or high fistulas, active sepsis, a need for staged planning or perianal Crohn's disease.
- ماذا تتضمن
- It often provides a safe first stage before definitive surgery. A draining seton usually controls inflammation but is not necessarily definitive treatment by itself.
05LIFT
LIFT PROCEDURE
The fistula tract is ligated and divided in the intersphincteric plane without intentional sphincter division.
- متى تُبحث
- Selected transsphincteric fistulas where sphincter preservation is a priority.
- ماذا تتضمن
- The intersphincteric tract is identified, isolated and closed. Healing is affected by branches, previous operations and Crohn's disease.
06ADVANCEMENT FLAP
ADVANCEMENT FLAP
The internal opening is closed and covered with a flap of healthy tissue, aiming to avoid wide sphincter division.
- متى تُبحث
- High or complex fistulas and cases in which fistulotomy would carry unacceptable functional risk.
- ماذا تتضمن
- The tract is cleaned, the internal opening is closed and covered with a rectal or anodermal flap. Recurrence or a change in continence remains possible.
07FiLaC
FiLaC LASER TREATMENT
A radial fibre applies controlled energy inside the tract, aiming to close it without intentional sphincter division.
- متى تُبحث
- Selected, mainly high or complex fistulas, after mapping and control of active infection.
- ماذا تتضمن
- FiLaC may limit surgical trauma, but does not guarantee healing and has not been proven superior for every fistula. Comparative and long-term evidence remains limited, and repeat or different surgery may be required.
رسم تشريحي أصلي واقعي للتثقيف — وليس صورة لمريض.
التخطيط والسلامة
Protecting continence and managing recurrence risk
No technique guarantees healing in every patient. Persistence or recurrence and continence risk depend on tract height and branches, sphincter involvement, baseline function, previous surgery and Crohn's disease. In complex cases, the safest treatment may require more than one stage.
MAPPING
The relationship between tract and sphincters comes before procedure selection.
CONTINENCE
Baseline function, previous childbirth and earlier operations affect safe planning.
CROHN'S DISEASE
Multiple or recurrent fistulas may require combined gastroenterology and surgical care.
FOLLOW-UP
Healing, drainage and signs of recurrent infection are reassessed after treatment.
الأسئلة
الأسئلة الشائعة
إجابات مختصرة قبل التقييم الجراحي الفردي.
01Are an abscess and a fistula the same?
No. An abscess is an acute collection of pus, while a fistula is an abnormal tract that may remain after infection.
02Are antibiotics enough for a perianal abscess?
Usually not once a collection has formed. Drainage is the main treatment; antibiotics are added only in selected clinical circumstances.
03Does everyone need an MRI scan?
No. MRI is used selectively for a deep, complex or recurrent fistula, after previous surgery or in Crohn's disease, when it will change planning.
04Which is the best fistula operation?
There is no single operation suitable for everyone. Choice depends mainly on tract anatomy, sphincter involvement, baseline continence and previous surgery.
05What is a seton, and does it mean treatment has failed?
A seton is a dedicated thread or loop that maintains drainage. It is often a deliberate first stage to control infection and protect the sphincters, not a failure.
06Is FiLaC laser suitable for every fistula?
No. It may be considered in selected cases, but it does not guarantee healing and has not proved superior for every anatomy. Selection follows mapping and infection control.
07Is there a risk of incontinence?
Risk varies with anatomy and the procedure. The sphincters and baseline continence are therefore assessed before treatment is selected.
08Can a fistula recur?
Yes. Recurrence is influenced by complex anatomy, branches, active infection, previous operations and Crohn's disease. Follow-up is part of treatment.
09When is urgent medical assessment needed?
High fever or chills, rapidly worsening pain, swelling or redness, and significant systemic illness require urgent assessment, particularly in diabetes or immunosuppression.
الأدلة السريرية
الأدلة السريرية
يعتمد الاختيار النهائي على الحالة السريرية والتشريح والإرشادات الحديثة.
01ASCRS · Anorectal Abscess and Anal Fistula Guideline 2022Clinical guideline for diagnosis, drainage and surgical optionsالمصدر الرسمي02European Society of Coloproctology · Guideline 2024European guideline for cryptoglandular anal fistulaالمصدر الرسمي03NHS · Anal fistulaPatient information on symptoms, diagnosis and treatmentالمصدر الرسمي04ACPGBI · Anal abscess and fistulaPatient information from the British coloproctology associationالمصدر الرسمي05NICE · FiLaCGuidance on laser treatment and uncertainty in efficacy evidenceالمصدر الرسمي
هذا المحتوى تثقيفي ولا يغني عن الفحص الطبي. تُناقش الفوائد والمخاطر والبدائل بصورة فردية.
تقييم جراحي فردي
العملية المناسبة تبدأ بالتشخيص والاستطباب المناسبين.
تُراجع الأعراض والفحوص والبدائل أثناء الاستشارة.
عيادة REA MED والوصول إليها