Intersphincteric fistulas are the most prevalent fistulas encountered by a surgeon. In general, there are two surgical methods for treating intersphincteric fistulas: fistulotomy and fistulectomy. The advantage of a fistulotomy is less sphincter muscle destruction; the disadvantage is a higher recurrence rate. The advantage of a fistulectomy is a lower recurrence rate; the disadvantage is more sphincter muscle destruction and a higher flatus incontinence rate. Because of the disadvantages with both surgical methods, the authors have developed a new method for treating intersphincteric fistulas. The new method is a fistulectomy with seton. A fistulectomy with seton is a seton tightening of the remaining internal sphincter and subcutaneous external sphincter after coring out of the fistula tract. The advantages of this method are a lower recurrence rate due to complete removal of the fistula and a lower flatus incontinence rate due to the seton slowly cutting the remaining sphincter muscle. For that reason, the authors submit that fistulectomy with seton is the most effective operation method for treating intersphincteric fistulas, especially because fistulectomy with seton has many advantages such as a lower recurrence rate, a lower flatus incontinence rate, and less anal deformity.
Congenital Abnormalities ; Fistula* ; Flatulence ; Recurrence

Congenital median dermoid is an uncommon disease. Surgery is the main curative treatment. To review a clinical case and to summarise the characteristics and treatment experience of this disease, referring to the related literature, it is expected that we can provide more clinical thought and therapeutic method for congenital median dermoid fistula of nasal dorsum.
Dermoid Cyst ; congenital ; therapy ; Fistula ; congenital ; therapy ; Humans ; Nose ; pathology ; Nose Neoplasms ; congenital ; therapy

Child ; Female ; Hematemesis ; complications ; Humans ; Tracheoesophageal Fistula ; complications ; congenital

Adolescent ; Adult ; Fistula ; congenital ; Humans ; Male ; Pyriform Sinus

Double pylorus is either a congenital abnormality or an acquired complication of peptic ulcer disease. An accessory channel normally connects the lesser or greater curvatore of the prepyloric antrum with the duodenal bulb. Three cases of double pylorus, an unusual complication of peptic ulcer disease is herein reported. A peptic ulcer lay in the accessory channel in all cases. In one of the cases, the fistula closed spontaneously after Helicobacter pylori eradication. The remaining 2 patients became asympto-matic despite the persistence of the accessory channel.
Congenital Abnormalities ; Fistula* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Peptic Ulcer* ; Pylorus*

Adolescent ; Branchial Region ; Fistula ; congenital ; Humans ; Male ; Neck

BACKGROUND: Preauricular sinuses are congenital abnormalities caused by a failure of fusion of the primitive tubercles from which the pinna is formed. When persistent or recurring inflammation occurs, surgical excision of the infected tissue should be considered. Preauricular defects inevitably occur as a result of excisions and are often difficult to resolve with a simple suture; a more effective reconstruction technique is required for treating these defects. METHODS: After total excision of a preauricular sinus, the defect was closed by a plastic surgeon. Based on the depth of the defect and the degree of tension when apposing the wound margins, the surgeon determined whether to use primary closure or a posterior auricular flap. RESULTS: A total of 28 cases were examined. In 5 cases, including 2 reoperations for dehiscence after primary repair, reconstruction was performed using posterior auricular transposition flaps. In 16 cases of primary closure, the defects were closed using simple sutures, and in 7 cases, closure was performed after wide undermining. CONCLUSIONS: If a preauricular defect is limited to the subcutaneous layer and the margins can be easily approximated, primary closure by only simple suturing may be used to perform the repair. If the defect is deep enough to expose the perichondrium or if there is tension when apposing the wound margins, wide undermining should be performed before primary closure. If the extent of the excision exposes cartilage, the procedure follows dehiscence of the primary repair, or the tissue is not sufficiently healthy, the surgeon should use a posterior auricular flap.
Cartilage ; Congenital Abnormalities ; Fistula ; Inflammation ; Surgical Flaps ; Sutures ; Wounds and Injuries

An intersphincteric fistula is the most common type of fistula, about 70% of all fistulas, and is often encountered by the surgeon during anal surgery. The operative procedures include a simple fistulotomy, a fistulectomy, a cutting seton technique, and a sphincter-saving technique. Most posterior-located intersphincteric fistulas can be successfully treated by using the lay-open technique, but using that technique in cases of lateral- or anterior-located fistulas may result in incontinence or anal deformity. In this respect, a sphincter-saving technique has more advantage in sparing anal function than other procedures in cases of lateral or anterior fistulas, but the recurrence rate is high. The delayed open method with seton techniques have a low recurrence rate, but do not preserve anal function well. As mentioned above, the operative method for treating intersphincteric fistulas should be suitable for keeping sphincter tone and should have a low recurrence rate. This article discusses the rationale for and the estimated effectiveness of many operative methods for treating intersphincteric fistulas.
Congenital Abnormalities ; Fistula ; Imidazoles ; Nitro Compounds ; Recurrence ; Surgical Procedures, Operative

Vertebral anomalies-anal atresia-cardiac abnormalities-tracheoesophageal fistula-renal agenesis-limb (VACTERL) defects association is a rare congenital disease. While most scientific literature focus on the clinical presentation and management of pediatric patients with this condition, this paper focuses on the challenges faced by a 22-year-old primigravid, who was able to carry a pregnancy to term, despite the many anomalies associated with being afflicted with VACTERL.
Humans ; Tracheoesophageal Fistula ; VACTERL association ; Limb Deformities, Congenital

fistula, oroantral fistula, traumatic deformities and others. The age of patients ranged from 7 to 72 years, with mean follow up period of 21.6 months. There were 9 complications, of which four were partial necrosis, there infections, one total necrosis and 1 speech problem. Except for total necrosis, most of the recipient sites healed uneventually without severe morbidity. We consider that a variety of intraoral local intraoral local flaps can be available for reconstruction of small or moderate large intraoral soft tissue defects.]]>
Adipose Tissue ; Arteries ; Congenital Abnormalities ; Fistula ; Follow-Up Studies ; Humans ; Masseter Muscle ; Necrosis ; Oroantral Fistula ; Tongue