A rare treatment of the Fistula from the gluteal area up to anal canal with TEM procedure

Turgut Ipek, PROFDR, Erhun Eyuboglu, PROFDR, Erkal Ziylan, MD. Istanbul Kemerburgaz University

A 33-year-old male patient presented with complaints of progressively increasing pain, swelling and discharge in the right gluteal region of 18 mounths duration. His past history included a bullet injury in war. An MRI scan of gluteal region was performed to further characterise and define the extent of this discharge. A large caliber fistulous tract was running medially from the gluteal area up to anal canal. The features were suggestive of suprasphincteric fistula  with an opening at around 7 o'clock position above the dentate line. The inner mounth of the fistula were excised with transanal endoscopic microsurgery (TEM) operation. Primary reparir was performed by placing plug in the path of the fistula. At follow-up after 6 weeeks, he was pain-free at the gluteal area and gluteal signs had resolved. This resulted in satisfactory improvement in the social life of this patient.

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