Keyhole Deformity

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Keyhole Deformity

Postby longordeal » 26 Jul 2011, 19:07

Hello all,
About 4 months ago, I had a posterior superficial spincterotomy (like an LIS but in the 6:00 position) along with a fissurectomy to try to help heal an anal fissure. Unfortunately, not only has the fissure not healed, but the fissurectomy wound did not heal properly, leaving me with a deformity known as a "keyhole deformity." (Think of what an old skeleton key hole looks like).
For the last 2 months, I strongly suspect that I am leaking mucus through this deformity. I say suspect because I'm not positive this leakage isn't coming from the fissure itself as it heals, but this seems unlikely given the volume. Also, this is a classic result of a keyhole deformity, according to what i have read.
My question is, has anyone else out there had a similar deformity? If so, what was it like for you, how did you handle it, and what did your doctor suggest/do? My current doctor basically says this is a minor issue I should deal with, but I'm 27yo and will not accept soiling myself or using cotton gauze for the rest of my life. I understand there are a couple of surgical procedures out there that can correct this.
I'm really looking forward to speaking with someone who has had this condition as well. It has really altered my life and frankly it is driving me crazy.
Thanks! And I wish you all the best of luck.
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Re: Keyhole Deformity

Postby Guest » 28 Jul 2011, 08:59

Hi. I'm going to give your thread a bump. Hopefully someone can help as I have only read about this.
I'm trying to understand why your LIS incision was at 6'oclock position. I thought that fissure are commonly located at 6 or 12 o'clock and the LIS incision was made on the left or right side?
Hopefully someone can respond to your question with more knowledge than I have:)
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Re: Keyhole Deformity

Postby longordeal » 28 Jul 2011, 09:37

Hi Dawn,
Thanks. I really don't know why either and was under the impression that I was having an LIS. I have a new doctor, now, however, and he says that I did not have an LIS but instead a posterior midline superficial sphincterotomy. He says this isn't necessarily bad, but that is what I had.
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Re: Keyhole Deformity

Postby Deleted User 579 » 28 Jul 2011, 11:27

Hi Longordeal - I haven't read any accounts of a keyhole deformity on this forum. I will keep my eyes open and let you know if I see anything. Every post I've seen that talks about fissure surgery discusses LISs. My understanding is that sphincterotomies at the 6 o'clock position were not done anymore precisely because of such a a complication.
There are folks who have had LIS and also experience leakage - that's a possible side effect of an LIS too. However, maybe you can talk to your doctor about possible options to correct the keyhole deformity. Consulting with a few very good colorectal surgeons would probably to a good thing to do too. I've heard of people emailing surgeons to ask questions, so if you find a good surgeon online, it might not hurt to send an email inquiry as well.
I really hope you get some answers!
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Re: Keyhole Deformity

Postby longordeal » 28 Jul 2011, 14:12

Hello hopetoheal,
Thanks for your reply. I have read the same thing about the posterior superficial midline sphincterotomy - that it is not recommended exactly because of this. Ironically, however, the CRS that I saw after my surgery (I moved) said that the first surgeon who performed the surgery (whom he did not know) had made the right decision in this case, and he had even written a paper favoring this procedure, so I don't know.
In any case, at this point I'm stuck with what i have. Today I made an appointment with who I understand to be a very good CRS for Monday to get a second opinion and learn about some other options.
Where would I even find a CRS who would be willing to answer questions like this via email without examining me??
Thanks for your support!
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Re: Keyhole Deformity

Postby Guest » 28 Jul 2011, 15:03

Hey longordeal,
I read every thread on here prior to my LIS 9 months ago and I don't recall anyone posting about a keyhole deformity. There may be something I missed though.
There's one person who stands out in my mind who had a LIS incision where I believe would be at 6'oclock. Her name was Jen. You may be able to search the threads and find her surgery experience before I could as I am a little busy today,Lol. I recall her having a long recovery and a hard time healing her fissure. I believe it took her about 6 months after LIS.
Hope this helps. I have no idea of who you could consult with through e-mail but I have also read of other folks discussing their situation by email before seeing a CRS. I really don't know how common that is?!
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Re: Keyhole Deformity

Postby Guest » 28 Jul 2011, 15:08

ps..I experienced leakage after LIS, but it's like you didn't wipe good after a bm leakage. There's a thread "8 months post up with leakage" (or close to that title) where you can see what many of us have experienced. I never had anything green or yellow with my leakage.
I know some of the fissurectomy folks who are post-op have been discussing having some of this going on.
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Re: Keyhole Deformity

Postby Deleted User 579 » 28 Jul 2011, 15:51

When I was researching LIS procedures prior to my own operation I came across articles in medical journals describing the surgery. Very often the authors' names and hospital affiliations are provided before the abstract of the article, or you can google the names of the authors. I almost contacted a CRS at Mount Sinai Hopsital in Toronto because she wrote a very informative academic article on her LIS methods, and I saw on her website that her credentials were quite impressive. Her website also had her email address on it. I don't know that every doctor replies, but I know that some actually do. I think as long as you don't ask questions about how they would treat you, but just general questions, a doctor might be happy to respond.
I'm very glad you found a good CRS and that you can get another opinion. Please let us know how that goes ... and good luck!
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Re: Keyhole Deformity

Postby May » 29 Dec 2015, 11:19

I know this is an old post, but did you have any treatment to correct a keyhole deformity? I'm in a similar position. :(
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