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Perianal abscess --> fistula?

Posted , 2 users are following.

ohmydearnyc
ohmydearnyc

On December 2, 2017 I went to the ER with incredible pain in my rectal area which, long story short, turned out to be a perianal abscess. I have been dealing with an incredible amount stress -- my father had been admitted to hospice the week prior and I have been his caregiver. At the end of December, he passed away.

On December  3, I had an I&D and was sent home to recover on Flagyl & Cipro for 10 days. I ended up with pneumonia presumably from the general anesthesia and was on another antibiotic for 10 days. I was told not to bathe for the healing period, no sitz bath, nothing. I keep the area clean with a perianal squirt bottle and gauze.

I was examined at six weeks out and it looked healed however another two weeks later, a pinhole seemed to appear with pus and blood coming from it. I went back to the original surgeon again today who says there is a "20% chance" of a fistula forming -- which he said when I had been admitted -- but the internet says 50% chance. This is a good emergency room and seemingly good doctor. Not sure why his odds don't match up with my internet researching. In any case, he told me to come back in 4-6 weeks if it is still draining to schedule an OR visit to check for a fistula.

Stats from 12/3/17 on the abscess:

Small 2.1 x 1.6 x 1.8 cm abscess in the medial left gluteal fold. No definite extension to the adjacent sphincter muscles identified. No linear tract visualized to suggest fistula formation. No acute intra-abdominal abnormality. 

MY QUESTIONS:

Here are the stats on the surgery. Would you get a second opinion NOW or wait 4-6 weeks?

Is it normal to still be healing this long out after an abscess? 

What are the chances a fistula DID form?

Thank you!

0 likes, 3 replies

3 Replies

  • Guest
    Guest ohmydearnyc

    Posted

    Hi, I developed a rectal abscess September 2016, which led on to a fistula developing in the November. Have had MRIs to confirm this. Have undergone 4 operations to try and heal this, have had 2 seton stitches replaced to help close the fistula (as surgical intervention is the only treatment). A recent MRI showed there is an extension from my rectum which keep allowing the abscess to occur. On a daily basis I have pus and blood leaking from the fistula, are booked in for another procedure end of February next month. My consultant said that 2 out of 3 people who have an abscess will develop a fistula, due to the area of where it is. I wouldn’t focus on statistics, yours sounds exactly like mine did and took over 3 months for the doctors to agree and to send me for a scan to confirm this. The issue with myself is that the abscess is everywhere in my rectum and if he was to I+D the way it’s needing, he could damage the sphincter muscles and risk incontinence. He said it will be an ongoing issue for a long time and will require regular surgical procedures. Hope this helps. My advice would be to keep on at he doctors until they listen. Hope your keeping well, it affected my work greatly and are not long back since op in November. L 
    • ohmydearnyc
      ohmydearnyc Guest

      Posted

      Ugh this is so devastating. I am so sorry. I feel more determined to get a second opinion because this sounds like a fistula. I am so afraid of bowel incontinence. The original diagnosis said no fistula but I guess they can form. I thought if it was just blood and pus then maybe it wouldn't be a fistula. But I guess I am wrong. So devastating. What procedures are LEAST likely to cause bowel incontinence? Thank you.

  • ohmydearnyc
    ohmydearnyc

    Posted

    Just an update, definitely a fistula.
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