Clinical Examination for Complex Fistula in Ano: Relevance in Present Times -A Clinical Study

Abstract

Background: Fistula in Ano has been known as a chronic painful disease since centuries past with no proven well defined course of management even till the present times. This has given rise to various forms of treatment ranging from seton to flaps. Materials and Methods: Total 83 adult patients with age ranging from 16 to 70 years were studied over a span of 8 years starting from Jan‟10 to Dec‟17. Clinical findings were compared with MR Imaging
and correlated with Intraoperative Methylene blue injection. The findings were tabulated and compared regarding effectiveness of each method in determining the exact anatomy of the fistula and statistical significance was determined by Chi square test. Results: Our studies showed that the chances of detecting the internal opening by clinical examination is significantly better than MRI, however neither clinical examination nor MRI is a full proof
mechanism for detecting the type of fistula. Conclusion: Even though Imaging is better at detecting the fistula anatomy there is still a role for a proper clinical examination in outpatient department. Clinical Examination compares favorably with MR Imaging in detecting Internal Opening of a Fistula. Even in complicated Fistulas, a proper clinical examination is better than Imaging in detection of anatomy of a fistula, even though there is no statistically significant difference between the two methods.