Anal abscesses and fistulas

Matthew J F X Rickard*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

45 Citations (Scopus)


Anal abscesses and fistulas are a common part of surgical practice. Most abscesses simply need to be drained and most fistulas can be safely laid open. Excessive probing should not be attempted when draining abscesses as this may lead to iatrogenic fistulas. A small percentage of fistulas are complex and very challenging to manage. Management involves an accurate diagnosis and a balance between eradication of the fistula and maintenance of continence. A decision should be made, based on clinical evaluation and anal ultrasound (if available), whether the fistula can be laid open. If it cannot be laid open, a loose seton is placed and the sepsis is allowed to settle. Once the sepsis is quiescent, a definitive repair can be attempted. There are various techniques available including rectal advancement flap, fibrin glue and cutaneous flaps all of which are discussed.

Original languageEnglish
Pages (from-to)64-72
Number of pages9
JournalANZ Journal of Surgery
Issue number1-2
Publication statusPublished - Jan 2005
Externally publishedYes


  • Anal fistula
  • Peri-anal abscess


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