CLINICAL SPECTRUM OF FISTULA IN ANO AT TERTIARY CARE HOSPITAL

Objective: To determine the clinical spectrum of fistula in ano at tertiary care hospital. Patients and Methods: The six months clinical study was conducted at tertiary care hospital on fifty participants. The specific patients of fistula in ano were clinically diagnosed and selected randomly. The clinical history was obtained in all the patients and the clinical examination including general physical examination, per rectal and proctoscopic was done in all individuals. All the patients were explored by routine investigations as ECG, chest, X-Ray before surgery. Fistulogram was done in selected cases and the patients were managed with fistulectomy or fistulotomy for fistulae and were had follow up visits for six months while the frequency / percentages (%) and means ±SD computed for study variables. Results: during one year study period total fifty patients of fistula in ano were explored and studied. the frequency for male and female population was 40 (80%) and 10 (20%) with mean ± sd for age of male and female individuals was 48.84±7.83 and 43.94±6.95 respectively. regarding the mode of presentation discharge 11 (22%), pain and swelling 04 (8.0%), peri anal irritation 05 (10%), past history of peri anal abscess 30 (60%), number of external opening one (94%) and ≥2 (6.0%), the types of surgical treatment fistulectomy 45 (90%), fistulotomy 04 (8.0%), fistulectomy with lateral sphinctorotomy 01 (2.0) and the post operative outcomes complete healing 40 (80%), bleeding 03 (6.0%), recurrence of fistula 05 (10%) and haematoma 02 (4.0%). Conclusion: Fistula in ano is an important, commonest ailment and all the cases should bear surgery, fistulectomy is better than fistulotomy Keywords: Fistulectomy, Fistula in ano and fistulotom