Scientific Articles
The yield of routine histopathology in fistula-in-ano
Authors:
Umesh Jayarajah ,
Faculty of Medicine, Colombo, LK
Isuru Sampath Almeida,
Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka, LK
Dharmabandhu Nandadeva Samarasekera
Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka, LK
Abstract
Introduction: Fistulae-in-ano with a specific aetiology such as TB and Crohn’s are usually complex and challenging to treat. This study was aimed to determine the yield of routine histological analysis in fistula-in-ano, in detecting specific aetiology.
Methods: A descriptive study was conducted at the Professorial Surgical Unit, National Hospital of Sri Lanka, Colombo from 2001-2016. Histopathology reports of all patients without a histological diagnosis and who underwent surgery for fistulae-in-ano were analysed.
Results: A total of 215 patients [median age:40 years (range:14-73), males=179(82.8%)] were analysed. The majority (75%, n=161) were simple fistulae. Histological evaluation revealed inflamed granulation tissue in 94.9% (n=204) of patients. Five (2.3%) patients had conclusive evidence of Crohn’s disease and three (1.4%) had tuberculosis. One patient (0.5%) had evidence of adenocarcinoma with mucinous differentiation. Significant proportion of fistula with underlying specific aetiology were complex fistulae (82% vs. 22%, p<0.001) and associated with abscess/collections (45.5% vs. 11.8%, p<0.001). Age, type of fistula, level of internal opening, recurrence and presence of haemorrhoids were comparable in those with and without a specific aetiology.
Conclusion: Complex fistula and presence of abscess/ collection were associated with a specific aetiology. Routine histopathological analysis in patients presenting with fistula in-ano should be performed as clinical prediction based on the nature of fistula may not be always accurate.
How to Cite:
Jayarajah U, Almeida IS, Samarasekera DN. The yield of routine histopathology in fistula-in-ano. Sri Lanka Journal of Surgery. 2020;38(2):37–41. DOI: http://doi.org/10.4038/sljs.v38i2.8698
Published on
31 Aug 2020.
Peer Reviewed
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