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- W2321532301 abstract "Supralevator fistulae with perforation to the rectum have deep and complicated fistul-ous tracts which penetrate all through the sphincter muscles often accompanied by rectal stenosis.The complexity of the lesion makes the true diagnosis difficult causing the recurrences even after the trials of repeated operations. The supralevator fistulae are made by the extension of abscess up along the retrorectal space and by the rupture of the retrorectal abscess into the rectum. Most of the perforations are situated midposteriorly or somewhat posterolaterally. Sometimes, especially in women, the perforations are situated laterally or ante4rolaterally. The modes of penetration through the rectal wall have some varieties ; 1) it directly per-forates to the rectum 2) the fistulous tract runs between the intersphincteric space for some distance and then perforates to the.rectum 3) it makes a pool between the intersphincteric space and then perforates to the rectum. The treatments consist firstly of confirmation of the site of perforation to the rectum by opening widely the fistulous tracts. The puborectalis has to be reserved to insure the continence. The perforated site is fully curetted and drained. Temporary covering colos-tomy is usually required when the perforation is large. When fistula is tried to be cured without colostomy, the tissues between the perforation and the levator are secondarily incised when the outer wound including superficial sphincters has become fused with granulation. Recently, sphincter-reserving procedures are also adopted to treat this type of fistulae.The results so far are excellent without a case of recurrence and the continences are fairly well reserved." @default.
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- W2321532301 date "1980-01-01" @default.
- W2321532301 modified "2023-10-03" @default.
- W2321532301 title "7. Supralevator Fistulae with Perforation to the Rectum" @default.
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- W2321532301 doi "https://doi.org/10.3862/jcoloproctology.33.471" @default.
- W2321532301 hasPublicationYear "1980" @default.
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