Retrorectal Dermoid Cyst Manifested as an Extrasphincteric Perianal Fistula - Case Report

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Retrorectal Dermoid Cyst Manifested as an Extrasphincteric Perianal Fistula - Case Report

A. Karagjozov, I. Milev, S. Antovic, E. Kadri
Clinical case, no. 6, 2014
Retrorectal tumors are very rare but well defined pathologicalentities in the literature. Also, an extrasphincteric fistula is avery rare form of perianal fistula which makes our case a veryunusual and rare one, especially by the fact that it wassuccessfully treated with the first operation and withoutprotective stoma formation. The patient was first treated inhospital for a retrorectal abscess that had spontaneouslyruptured in the postanal space. Because of the constantdrainage of the suppurative content from the postanal openingin the following months, MRI and fistulography wereperformed, registering cystic formation in the retrorectal spacewith fistulous communication with the rectum above andcompletely separate from the sphincter mechanism. After thatthe patient was admitted for definitive treatment. Theoperation was performed with the patient in a prone jack-knifeposition. Complete excision of the cyst with the fistulouscommunication was performed and the rectum was sutured intwo layers with separate slowly absorbable sutures. The woundwas laid open and the patient was discharged on the 5th postoperativeday. After about ten months the defecation isnormal, the wound is sealed and there are no signs of inflammationand secretion locally.