Chlamydia trachomatis

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Chlamydia infection is caused by Chlamydia trachomatis. The organism can cause proctitis similar to that of CD. Untreated disease may become ulcerated causing fistulas, abscesses, or rectal stricture, which may be misdiagnosed as adenocarcinoma. Diagnosis is usually made by serology. Treatment consists of oral tetracycline or erythromycin, 500 mg 4 times a day for 3 weeks. Rectal strictures are primarily treated medically; in case of failure, surgical resection with coloanal anastomosis may be required.

Anal Stenosis House Flap

FIGURE 91-3. House shape (advancement) flap: A, House shaped flap is created; B, the flap is advanced into the anal canal; and C, sutured in place. Reprinted from Fundamentals of Anorectal Surgery, 2nd Edition, Wexner et al, Fistula in ano and anal stenosis (Fig 14.12, page 221). Reproduced with permission from Elsevier Ltd.

FIGURE 91-3. House shape (advancement) flap: A, House shaped flap is created; B, the flap is advanced into the anal canal; and C, sutured in place. Reprinted from Fundamentals of Anorectal Surgery, 2nd Edition, Wexner et al, Fistula in ano and anal stenosis (Fig 14.12, page 221). Reproduced with permission from Elsevier Ltd.

Plasty Excision

FIGURE 91-4: S-plasty. A, Perianal skin lesion requiring removal of large skin area; B, area of perianal skin excised, lateral curves incised into buttocks; C, curves of skin advanced into perianal defect and secured laterally to produce S-shaped closure of rotated flaps. Reprinted from Fundamentals of Anorectal Surgery, 2nd Edition, Wexner et al, Fistula in ano and anal stenosis (Fig 14.13, page 221). Reproduced with permission from Elsevier Ltd.

FIGURE 91-4: S-plasty. A, Perianal skin lesion requiring removal of large skin area; B, area of perianal skin excised, lateral curves incised into buttocks; C, curves of skin advanced into perianal defect and secured laterally to produce S-shaped closure of rotated flaps. Reprinted from Fundamentals of Anorectal Surgery, 2nd Edition, Wexner et al, Fistula in ano and anal stenosis (Fig 14.13, page 221). Reproduced with permission from Elsevier Ltd.

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