Hydrogen peroxide injection followed by methylene blue into external openings of perianal fistulae : a new Simple method of track delineation

Abstract EN

Perianal fistula is common in Saudi Arabia, the most common predisposing cause being an anal gland abscess.

Although tuberculosis and inflammatory bowel disease are not rare in this part of the world, they contribute little to the aetiology of anal fistulae.

Delineation of the tract is the central step in proper tract excision that allows for permanent cure with minimal recurrence.

The use of dyes in this respect is well-known, but the combined injection of hydrogen peroxide followed five minutes later by methylene blue through the external orifices of the fistula was not used before.

In this study, which was done during the period from January 1995 to December 1997, 60 patients having fistula-in-ano were selected randomly, and this method was applied to them which helped in complete tract visualization and excision.

In the present series 84 % of the patients were males, with a mean age of 35.6 years.

Most were Saudi citizens (89 %).

The type of fistula was low in 83 % of the cases.

None of the patients had any of the specific granulomatous disease.

Twelve patients (22 %) gave a history of previous surgery for the same lesion with recurrence.

The follow-up period was 35 months.

There were 3 recurrences (5 %) ; all were diabetics.