A complex Fistula-In-Ano presenting as an extension in Rt. iliac fossa: A Case study

Abstract

Background - Systemic diseases like diabetes, hypertension etc are at higher risk of perianal diseases. A complex anal fistula, which is associated with diabetes are high complication rates and healing impairments. Treatment of fistula in ano depends on the location of the fistula, amount of anal sphincter involved in the fistula, and the underlying disease process. Prevention of recurrence and controlling the purulent discharge by surgical method are the definitive treatment of fistula in ano. Here, we present a complex case of Fistula in ano in uncontrolled diabetes mellitus patients which as an extension towards right iliac region and right inguinal region which was treated by surgical intervention.

Case presentation – a thirty-year-old diabetic male patient come to us for recurrent fistula in ano with swelling at right iliac and inguinal region. We do surgical intervention and discharged on 9^th post operative day. A follow up examination of post operative wound was taken after 2 days interval respectively. After 3 months, fistula track was completely healed.

Conclusion: fistula in ano is a complex disease in diabetic patients and imposes challenges to the surgeon. Early diagnosis and appropriate management is the key to success. Proper assessment and mapping of the tract is very important before going in for a definitive surgery.