Seton Application in Complex Perianal Fistula: Video Presentation

Abstract

Anal fistulas are non-physiological tract-like structures that open into the perianal skin starting from the distal rectum or anal canal and arise from abscesses on the basis of infection in the rudimentary glands around the dentate line. Recurrence rates vary between 10%-50% and this disease affects 2% of the society. Anal fistulas are classified as ischioanal, subanodermal, intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric, and spontaneous remission is not possible in this disease. Physical examination, contrast enhanced pelvic magnetic resonance imaging and endoanal ultrasonography are used in the diagnosis of this disease, which presents with symptoms such as fever, fatigue, soiling and pain. In this clinical picture, which may also be associated with Crohn’s disease, the ultimate treatment is surgery, and in this video presentation, we aimed to demonstrate a seton revision and tract curettage treatment in a patient who had previously undergone seton placement procedure for an extrasphincteric fistula.

Keywords

• complex perianal fistula
• curettage
• seton