Trummer C, Ruf G
Chirurgische Universitätsklinik, Abteilung Allgemeine Chirurgie mit Poliklinik, Freiburg.
MMW Fortschr Med. 2001 Jan 18;143(3):29-32.
Anorectal abscesses and fistulas are among the most common anorectal lesions. They represent different phases of one and the same condition, the abscess being the acute manifestation, the fistula the chronic form. In the event of a strong suspicion, rapid referral to hospital, preferably one specializing in proctology, is indicated. The treatment of choice of both abscesses and fistulas is surgery. Abscesses are widely incised and decompressed. Fistulas showing signs of fresh secretion may be treated initially by the insertion of a thread, and subsequently undergo definitive surgical treatment. The surgical procedure is determined by the site of the fistula. Attendant risks include recurrence and incontinence. When fistulas occur in Crohn's disease, the indication for surgical treatment must be stringently applied. In the absence of complications, postoperative healing of the wound should be checked regularly.
肛管直肠脓肿和肛瘘是最常见的肛管直肠病变。它们代表同一疾病的不同阶段，脓肿是急性表现，肛瘘是慢性形式。如果高度怀疑，应迅速转诊至医院，最好是专门的直肠科医院。脓肿和肛瘘的首选治疗方法是手术。脓肿需广泛切开并减压。有新鲜分泌物迹象的肛瘘最初可通过挂线治疗，随后进行确定性手术治疗。手术方式取决于肛瘘的部位。相关风险包括复发和失禁。当肛瘘发生在克罗恩病时，必须严格掌握手术治疗指征。在没有并发症的情况下，应定期检查术后伤口愈合情况。
