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Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Seton dropped out by itself!!



06-21-2015, 05:39 AM   #1
droopymonthly
 
Join Date: Mar 2015
Location: Adelaide, South Australia, Australia
Seton dropped out by itself!!

Two weeks ago, the surgeon drained my perianal abscess and then he put setons in all my fistula to keep drainage. Just a moment ago, when I was going to do daily sitz bath, I found the seton was out and my wife said she can see nothing at my bottom right now.

I am so so shocked!!
Attached Images
File Type: jpg dropped seton.jpg (99.0 KB, 33 views)
06-21-2015, 06:17 AM   #2
nogutsnoglory
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Join Date: Sep 2009
Location: New York

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Please call your surgeon immediately.
06-21-2015, 10:10 AM   #3
WingedVictory
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Join Date: May 2015
Location: New York
Uh oh, time to break out the ol' duct tape.

In all seriousness, I would get a consultation ASAP and likely prepare to have another one placed. Judging by that pad your fistula seems active enough warrant it.
06-23-2015, 09:39 AM   #4
droopymonthly
 
Join Date: Mar 2015
Location: Adelaide, South Australia, Australia
I feel not good. Before surgery(2 weeks ago), the surgeon said he will clear all my fistulas and put seton stitch in each fistula to help drainage in order to prevent further abscess formed. Thus, I have nothing to worry about. But after surgery, he said the thing is very bad, the fistula's level is very very high. He failed to locate the internal hole of the fistula and he had to drain the abscess and put a tube to help drain. The ibd nurse said in my above picture, it is a tube, not seton stitch(since the surgeon failed to locate the internal hole, he did not put seton as original planned). The tube is scheduled to be removed in 2 weeks, but it is sometimes dropped out in advanced. It is quite normal, and I have nothing to worry about.
I still feel very very sad. The surgeon said he drained my abscess and he hope the remicade could heal my high level fistula. But what if it is not? What should I do if Remicade does not work on me or not as good as to heal the fistula? Is there any way to control the high level fistula? The following is part of surgeon's operation.

EXAMINATION UNDER ANAESTHESIA AND INCISION AND DRAINAGE OF PERIANAL ABSCESS WHO, GA, IV ABX, RIGID SIGMOIDOSCOPE
RADIAL INCISION OVER RED FLUCTUANT AREA - PUS SAMPLED FOR M, C + S
LOCULES BROKEN DOWN (SUPERFICIAL) BUT CLEAR CAVITY EXTENDING CEPHALAD BEYOND EXTENT OF DIGIT
CAVITY PROBED WITH LOCKARDT MUMMERY PROBE AND ALTHOUGH PUS SEEN IN RECTUM, COMING FROM PROXIMAL TO EXTENT OF EISENHAMMER (AND VIEW ON RIGID SIG LIMITED BY BLOOD AND MUCUS)
THIS CAVITY SEEMED JUST OUTSIDE RECTUM AND LIKELY IN INTERSPHINCTERIC PLANE
H2O2 IRRIGATION AND NACL IRRIGATION, HAEMOSTASIS
PENROSE DRAIN TO CAVITY (SILK SUTURE X3) AND PACKED WITH RIBBON KALTOSTAT
PERINEAL SINUS PROBED AND SHOWN TO EXTEND TOWARDS RIGHT GROIN (VERY SUPERFICIAL AND BLIND ENDING) - LAID OPEN, WASHED (NACL) AND KALTOSTAT LAID ON OPEN WOUND - BIOPSY TAKEN
PERIANAL ABSCESS MOST FLUCTUANT AT 3 O'CLOCK - CAVITY EXTENDING CEPHALAD BEYOND EXTENT OF DIGIT AND LIKELY IN INTERSPHINCTERIC PLANE
FISTULA BUT INTERNAL OPENING NOT FORMALLY IDENTIFIED THUS FALSE OPENING NOT CREATED
PERINEAL SINUS - BLIND ENDING ? CROHNS OR HIDRADENITIS
SPECIMENS SAMPLED - PUS FOR M, C + S (ABSCESS), TISSUE FOR HISTOLOGY (PERINEUM) EAT AND DRINK ONCE AWAKE
DVT PROPHYLAXIS TONIGHT
CONTINUE IV ANTIBIOTICS
CHASE M, C + S AND HISTOLOGY
ANALGESIA

Last edited by droopymonthly; 06-23-2015 at 10:46 AM.
06-23-2015, 10:06 AM   #5
AFS
 
Join Date: Dec 2014
My story is very similar to yours. I had a high anal (actually rectal) abscess, about 7 to 8 CM above anus right next to rectal wall. The Internal Opening of the fistula was right next to the abscess on the rectum. I underwent multiple -- 6 in all -- I&D procedures to drain the abscess. I lived with a seton for 1 year. CRS, frustrated with not being able to control the abscess from flourishing again, tried different techniques in each I&D, with mushroom catheter being tried in my last I&D. The mushroom catheter is a tube like yours. It will fall out, even though it is usually held in place by a suture to the skin.

All my I&D surgeries in the USA failed to achieve their intended purpose - to drain the abscess, bring the pain level down, and enable a fistula repair procedure. I never reached the point of even discussing fistula repair surgery with my CRS.

Sorry to sound so negative, but I wish you the very best. Keep the fight. There is light at the end. Just that with this disease, it takes time and patience.
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Abscess Fistula Sufferer (11/2013 - 6/2015)
My anal fistula story - https://fistulapatient2patient.wordpress.com/
06-23-2015, 10:21 AM   #6
lgpcarter
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Join Date: Jun 2013
Location: Canada

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You guys are having a rough go! I had amazing luck with Remicade keeping my fistulas closed and happy for over 10 years. I really hope it works for you.
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Diagnosed in with Crohn's in large and small bowel in 2000.

Seton placement (2) and fistulotomy December 2013. Setons removed July 2014.

Laparoscopic Right Hemicolectomy July 2016, 25 cms removed

Current meds: Entyvio every 8 weeks, Imuran 50 mg, Flagyl and Cipro 500 mg twice a day
Previously: Remicade, Humira, Simponi, Pentasa, Sulphasalazine, Entocort, Stelara, Methotrexate, Prednisone
06-23-2015, 10:42 AM   #7
droopymonthly
 
Join Date: Mar 2015
Location: Adelaide, South Australia, Australia
I had amazing luck with Remicade keeping my fistulas closed and happy for over 10 years.
It is so nice to hear that.
However, if remicade healed your fistula. Why you state "Seton placement (2) and fistulotomy December 2013. Setons removed July 2014."? And, why you are not using Remicade right now according to your Current meds?
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Crohn's Disease Forum » Surgery » Fistulas, Fissures and Abscesses » Seton dropped out by itself!!
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