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Epidemiology of Anal Fistula and Abscess

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Anal Fistula and Abscess

Part of the book series: Coloproctology ((COLOPROCT))

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Abstract

Perianal abscess and anal fistula are common anorectal benign diseases, known since ancient Egypt.

Very recent studies have better defined their epidemiology with a mean prevalence of 8–23 per 100,000 people. Data confirm that 90% are cryptogenetic but IBD-associated lesions should always be considered because a mean prevalence of 4 per 100,000 people was recently calculated. The crypto-glandular hypothesis proposes that infection of an intersphincteric gland leads to fistulation out to the perianal skin. However, not all anorectal abscesses lead to persistent fistula. Moreover, other causes such as tuberculosis, trauma, hidradenitis suppurativa, HIV infection, sexually transmitted disease, radiotherapy, or malignancy should always be excluded. The mean age of first presentation is reported to be 40 years in both sexes but men are twice as likely as women to develop perianal abscess or anal fistula. Smoking is still an important host risk factor. Research is moving into the comprehension of the complex interaction of host, local pro-inflammatory signals, and infections but data about microbiological factors in term of occurrence or recurrence are controversial.

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Authors and Affiliations

  1. General Surgery, Luigi Sacco University Hospital, Milan, Italy

    Andrea Bondurri

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  1. Andrea Bondurri
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Correspondence to Andrea Bondurri .

Editor information

Editors and Affiliations

  1. Clinica Chirurgica, Catholic University, ROMA, Roma, Italy

    Carlo Ratto

  2. Dept. of Abdominal Surgery, Catholic University, ROMA, Roma, Italy

    Angelo Parello

  3. Dept. of Abdominal Surgery, Catholic University, ROMA, Roma, Italy

    Francesco Litta

  4. Dept. of Abdominal Surgery, Catholic University, Roma, Italy

    Veronica De Simone

  5. Proctology Unit, Dept. of Abdominal Surg, Foundation University Hospital “A. Gem, Roma, Roma, Italy

    Paola Campennì

Section Editor information

  1. Proctology Unit, University Hospital “A. Gemelli”, Catholic University, Rome, Italy

    Veronica De Simone

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Bondurri, A. (2021). Epidemiology of Anal Fistula and Abscess. In: Ratto, C., Parello, A., Litta, F., De Simone, V., Campennì, P. (eds) Anal Fistula and Abscess. Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-030-30902-2_1-1

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  • DOI: https://doi.org/10.1007/978-3-030-30902-2_1-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-30902-2

  • Online ISBN: 978-3-030-30902-2

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