Abstract:
Objective To determine the positive yield of routine
histopathology in patients undergoing surgery for fistula
in-ano.
Method Histopathology reports of all the patients who
underwent surgery for fistulae-in-ano over a period of
36 months were reviewed.
Results Analysis included 84 patients of which 73 (87%)
were male subjects. The mean age was 39.4 years (range
11–68). Forty-one (49%) had recurrent fistulae. Granulomatous
diseases such as Crohn’s disease and tuberculosis
(TB) were suspected in six patients. However, of the
six patients, confirmation of the disease status was obtained only in three patients: stains for acid-fast bacilli
confirmed TB in two (2.4%) patients and colonoscopy
and biopsy confirmed Crohn’s disease in one (1.2%)
patient. All three patients had recurrent fistulae.
Conclusion As the positive yield of routine histopathology
is minimal, we do not recommend routine histopathology
for fistula in-ano, except for those presenting
with recurrent fistulae and those with clinical suspicion of
an underlying disease such as TB, HIV or Crohn’s
disease.
