Anal fistula
A 37-year-old man presents to the clinic with complaints of persistent pain and swelling in the anal region for the past three months. He reports a history of recurrent anal abscesses that have required drainage on two occasions within the last year. The patient describes the pain as throbbing, worsening during bowel movements, and often accompanied by a foul-smelling discharge. He also notes occasional itching around the anus but denies any fever, changes in bowel habits, or significant weight loss.
On physical examination, there is tenderness and swelling around the anal area, and an external opening is observed near the midline of the perianal region, with a visible discharge. Digital rectal examination reveals a fistulous tract extending from the external opening to the anal canal. No masses or significant abnormalities are found in the rectum.
The patient is diagnosed with an anal fistula secondary to the previous abscesses. He is informed about the condition and the recommended treatment, which involves surgical intervention to lay open the fistula tract. The patient is scheduled for a fistulotomy and is given instructions on postoperative care, including hygiene measures and pain management. A follow-up appointment is arranged to assess healing and recovery after the procedure.
a). Rectal bleeding
b). Persistent pain and swelling in the anal region
c). Severe constipation
d). Foul-smelling gas
a). History of hemorrhoids
b). History of recurrent anal abscesses
c). Previous gastrointestinal surgeries
d). Chronic diarrhea
a). Internal hemorrhoids
b). A visible external opening with discharge
c). Tumors in the rectum
d). Skin tags around the anus
a.) Antibiotic therapy
b.) Dietary changes
c). Fistulotomy
d). Application of topical ointments
