Fistula-in-Ano Complicated by Fournier's Gangrene Our Experience in North-Eastern Region of Nigeria.
BACKGROUND
Fistula-in-ano when complicated by Fournier's gangrene is an unusual finding and always carries high morbidity. This study details our experience in managing 10 cases.


METHODS
Case files of all patients managed in University of Maiduguri Teaching Hospital and Federal Medical Center of Yola and Gombe from January, 2007 to December, 2011 were retrieved from Medical Record Departments and other Hospital Records. These were analyzed for demographic, clinical and pathological variables, the type of treatment and follow-up.


RESULTS
A total of 10 men with a mean age of 50.5 years (35-60) were managed in the period of study. Nearly, 50% of the patients were farmers, 30% businessmen and 20% were civil servant. 7 (70%) of these patients presented with Fournier's gangrene within 4 weeks of development of fistula-in-ano and the rest within 8 weeks. 4 (40%) of these patients had inadequate drainage of their perianal abscess and 2 (20%) had incision and drainage. Another 4 (40%) had spontaneously rupture of the perianal abscess. 6 (60%) of the fistula-in-ano was submuscular, 30% subcutaneous and 10% were complex or recurrent. Nearly, 20% of patients had fistulotomy and seton application for adequate drainage. Mucosal advancement flap was performed in 5 (50%) and fistulotomy in 3 (30%) patients. Another 30% had fistulotomy and continuing sitz bath.


CONCLUSIONS
Cryptoglandular infection is an important cause of perianal abscesses and fistula-in-ano and if poorly managed results in Fournier's gangrene. Early broad spectrum parenteral antibiotic therapy and primary surgical treatment can prevent Fournier's gangrene.
Department of Surgery, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria ; Department of Surgery, Federal Medical Centre Yola, Yola, Adamawa State, Nigeria.
Abubakar A
AA
Bakari
Department of Surgery, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
Nuhu
N
Ali
Department of Surgery, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria ; Department of Surgery, Federal Medical Centre Gombe, Gombe, Nigeria.
Ibrahim A
IA
Gadam
Department of Surgery, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
Bata M
BM
Gali
Department of Surgery, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
Chubado
C
Tahir
Department of Surgery, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
Kdt
K
Yawe
Department of Surgery, Federal Medical Centre Yola, Yola, Adamawa State, Nigeria.
Adamu B
AB
Dahiru
Department of Surgery, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
Baba S
BS
Mohammed
Department of Surgery, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
Dauda
D
Wadinga
Fistula-in-ano; Fournier's gangrene; perianal abscess