부산대학교 도서관

The process of diagnosing anal abscess and fistula includes identification of the primary infection site in the anal canal and anatomical classification of the fistulous tract. This implies that a precise anatomical description of anal abscess or fistula is indispensable for an accurate diagnosis.Here, we describe a new classification of anal fistulas which we recently proposed, and then show how fistulas can be diagnosed using this classification system. Diagnostic procedures include a careful inspection and digital examination of the anorectum as well as a detailed questionnaire about the symptoms. Diagnostic imaging, such as fistulography, endoanal ultrasound or MRI, is also performed if necessary. As deep anal abscesses and fistulas do not appear on the surface, a digital examination, especially bidigital examination, is the most important diagnostic procedure. A careful inspection and bidigital examination are also important when performing surgery for anal fistula. Therefore, surgeons should continue to improve their bidigital examination skills.As perianal abscess may emerge as a manifestation of fatal necrotizing perianal infection (e.g. Fournier's gangrene), care should be taken not to disregard such situation. The differential diagnosis of anal abscess and fistula includes furuncle, hidradenitis suppurativa, pilonidal sinus, and Bartholin's gland cyst or abscess.