Cases of Surgical Treated Anorectal Fistulas Associated with Ulcerative Colitis

Sho Haneda, Yuji Funayama, Kouhei Fukushima, Chikashi Shibata, Kenichi Takahashi, Akihiko Hashimoto, Munenori Nagao, Kazuhiro Watanabe, Katsuyoshi Kudo and Iwao Sasaki

Department of Surgery, Division of General and Alimentary Tract Surgery, Tohoku University Graduate School of Medicine

Many complications are reported in ulcerative colitis, but fistula is uncommon and treatment is complicated. We report three cases of ulcerative colitis with anorectal fistulas, all in women in their thirties and forties. Fistulas developed 25, 9, and 12 years after the first attack. Case 1 and 2 had total colitis and case 3 left colitis, none of which were severe. All were treated surgically. Case 1 underwent total proctocolectomy and end ileostomy, case 2 total proctocolectomy and ileo-anal anastomosis, and case 3 transvaginal repair of the fistula and temporary loop ileostomy. In 1 to 3 years of follow-up, no fistula recurred. In conclusion, surgery was of benefit in cases of anorectal fistulas associated ulcerative colitis in remission. Surgerical procedure should be selected based on the disease in each case.

Key words
ulcerative colitis, anorectal fistula, rectovaginal fistula

Reprint requests
Sho Haneda Department of Surgery, Division of General and Alimentary Tract Surgery, Tohoku University Graduate School of Medicine
1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574 JAPAN

Accepted
March 30, 2005

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