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Fistula-in-ano
Case description
Digital rectal examination may reveal a fibrous tract or
cord beneath the skin. It also helps delineate any further
acute inflammation that is not yet drained. Lateral or
posterior induration suggests deep postanal or ischiorectal
extension.
The examiner should determine the relationship between
the anorectal ring and the position of the tract before the
patient is relaxed by anesthesia. The sphincter tone and
voluntary squeeze pressures should be assessed before
any surgical intervention to delineate whether preoperative
manometry is indicated. Anoscopy is usually required to
identify the internal opening.
cord beneath the skin. It also helps delineate any further
acute inflammation that is not yet drained. Lateral or
posterior induration suggests deep postanal or ischiorectal
extension.
The examiner should determine the relationship between
the anorectal ring and the position of the tract before the
patient is relaxed by anesthesia. The sphincter tone and
voluntary squeeze pressures should be assessed before
any surgical intervention to delineate whether preoperative
manometry is indicated. Anoscopy is usually required to
identify the internal opening.
