Previously undescribed treatment for persistent peritoneal-perineal fistula following proctectomy.
Persistent perineal sinus is a common complication following proctectomy for inflammatory bowel disease. Complete excision of the sinus tract and obliteration of dead space have been stressed as important aspects of treatment. A patient is described in whom the perineal sinus persisted despite three surgical attempts at cure. Combined perineal exploration and laparotomy revealed a communicating peritoneal-perineal fistula. A combined perineal and peritoneal approach may be indicated in treating the perineal sinus that persists despite perineal excision.
Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112.
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W
Browder
A
A
Carey
R F
RF
Ryan
D000038:Abscess / Q000209:etiology* / Q000601:surgery; D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications / Q000601:surgery; D004322:Drainage; D005260:Female; D005402:Fistula / Q000150:complications / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010502:Perineum / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D013203:Staphylococcal Infections / Q000209:etiology; D013211:Staphylococcus aureus