Anal Fistula with Seton But No Known Diagnosis of Chron's

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Anal Fistula with Seton But No Known Diagnosis of Chron's

Postby chuggs13 » 03 Sep 2012, 15:37

For a quick background, I'm a 28-year old woman, no diagnosis of Chron's or any other digestive issues. 6 years ago I had a Pilonidal cyst lanced and packed until healing. And about a year ago I noticed a lump closer to my rectum, I thought maybe it was something similar and went to my general care doctor. She stated it was a bartholean cyst, lanced it and told me to follow up with my OBGYN. During the time I saw my general care doctor and my OBGYN, I had lost health care coverage, so was learning to live with an open wound. After several months, my OBGYN informed me it was a perianal abcess and that I also had granulation tissue. He suggested a very easy outpatient surgery for incission and drainage. However, after a few months and weekly follow ups I was not seeing a resolution. So, I started researching online, and thought I may have a fistula. So, I followed up with a CRS. He confirmed my thoughts almost immediately, and scheduled me for a fistulotomy. I had my fistulotomy on Friday, and he had stated depending on if it cut through a lot of the sphincter muscles he would do one of two procedures, but did not tell me much about the second. I think mainly because we both believed I had a superficial and straight forward fistula that he could lay open. However, when I came through from anastesia, he told me it was more complex and went through a lot of muscle. He did not lay the tract open and instead now I have a large hole where the abcess was and I can see the start of the tract. It was not until today that I saw part of the seton, or what I believe is the seton he put in place. I'm still not sure if it is a draining seton or a cutting seton, because he did not stop by after I woke up, but only talked to my husband. I have a follow up in 1.5 weeks, and we'll find out more then. Originally I was told I would have to be off work for 2 weeks, but I really do feel great. I was not in much pain and have not been on any pain meds the last two days. The worst part had to have been the first BM post surgery. I had mine the morning after my surgery and I broke out into a full on sweat and thought I may pass out. I hadn't taken any pain meds since bedtime the night before, and the GA had fully worn off. I've had 2 more BMs since, and they have definitely been less painful. I'm ok sitting on soft surfaces for shorter periods of time and have taken a few walks with the dog.
Now here are my questions, a lot of what I read is people with setons/complex are those with some digestive issues pre-fistula like Chrone's. I had none of this, does anyone have similar experience they could share?
I have been able to find little reading material on seton usage in fistula surgery, does anyone have any good resources?
Thanks so much! This board has been an amazing help, I feel like it is the only place that has any information what so ever.
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Re: Anal Fistula with Seton But No Known Diagnosis of Chron's

Postby Savaici » 04 Sep 2012, 06:59

Hello, and welcome to the forum. Glad you have had your surgery!
The best resource that I have found for current information on all matters medical is uptodate.com . This is a pay site, and I have been a member, but am not now. It is $19.95 for a 7-day pass. This is the link for what I searched for "fistula and seton" :
http://www.uptodate.com/contents/search?search=seton+anal+fistula&sp=0&searchType=PLAIN_TEXT&source=USER_INPUT&searchControl=TOP_PULLDOWN&searchOffset=
I don't know if this link is of any help, but this is another I found: http://www.sma.org.sg/smj/4306/4306a6.pdf
Also, not sure where you are in the world, but if you are in the US, ask for your medical records to get an exact picture of what went on. I know you can get them in the UK too.
A member here, hopetoheal, had fistula surgery; also adam, arafat and derryboy. You might want to look at their posts, and others might come along with more information for you.
Hope things go well and the very best for your continued healing Image
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Re: Anal Fistula with Seton But No Known Diagnosis of Chron's

Postby 2aussieMom » 05 Sep 2012, 21:13

Here's a little information on use of a seton with fistula surgery. http://www.bowel-health.com/fistula.html'
" A seton a is thread of nylon, prolene, rubber or other material that is non absorbable and is placed through the fistula track with the purpose of keeping it open for a certain period of time."
You want to keep the track open so there is an opening for the drainage to go. If the drainage sits and builds up, you have another abscess.
Any time an abscess is drained (regardless what part of the body it involves), it is packed and a drain left in place to prevent the skin from healing over first. You always want healing to be from the inside-out.
These problems are found frequently with people with GI conditions due to the nature of their illness/symptoms. But there are plenty of people who develop these problems "just because they are special". Bet you wish you weren't!
Hope this helps a little. Get better quick.
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Re: Anal Fistula with Seton But No Known Diagnosis of Chron's

Postby chuggs13 » 12 Sep 2012, 20:03

So, I thought my CRS had done a seton, because I saw part of a stitch from my rectum. However, I actually received an advancement flap surgery. It's been almost 2 weeks since my surgery and I'm feeling pretty good. Today was my first day back at work and I'm feeling alright.
I wanted to talk a bit about the blessing in disguise this Fistula has been for me. On Monday at my follow up, my CRS sat me down and told me that during the surgery, he had found a polyp within my rectum. He knew what it was and surgically removed it. Once he received the results back from pathology, he told me that this was in fact a carcinoid tumor, which is a rare cancer. He told me this fistula surgery probably saved my life because I wouldn't have shown any symptoms and because the tumor was less than 1 cm, he could remove it fairly easily and it would not have metastasized yet. I have never felt so overwhelmed after a surgery. I went back for a follow up CT scan, which I received the results of today and he said there are no further signs of cancer. I will be going back in 1 month for a colonoscopy to check further for signs of cancer, and will have to continue down this trail in hopes that it never reappears.
I never over the last year thought that I would be thanking God for having a fistula surgery.
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Re: Anal Fistula with Seton But No Known Diagnosis of Chron's

Postby 2aussieMom » 12 Sep 2012, 22:09

This is Probably the best News on the boards!
You are incredibly lucky and blessed. Sounds like you also have a great doctor. Also good to know you are feeling so much better.
What's really amazing is that at 28 no one would suggest you have a colonoscopy just for screening. Usual age for screening is 50!
Thanks for taking the time to post.
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