Colorectal and General Surgery

10/10/2024

🔷COMPLEX FISTULAS are described by the American Society of Colon and Re**al Surgeons Standard Practice Task Force (SPTF) as involving:
✅ multiple tracts
✅ anterior location in a female
✅ recurrent fistula
✅ with Crohn’s disease
✅ preexisting incontinence
✅ with local irradiation
✅ >30% of external sphincter
⚪️high transsphincteric
⚪️suprasphincteric
⚪️extrasphincteric

09/10/2024

🔷ANORECTAL FISTULAS are categorized based on degree of sphincter involvement:

1) TRANSPHINCTERIC (30–60%)
➡️travel through both the internal sphincter and external sphincter and are further subdivided based on degree of external sphincter involvement:
⚫️low trans-sphincteric - involving 30% or less of the external sphincter
⚫️high trans-sphincteric - involving more than 30% of the external sphincter

2) INTERSPHINCTERIC (24–45%)
➡️ track through the internal sphincter alone before traveling through the inter-sphincteric space to reach the perianal skin

3) SUPRASPHINCTERIC (2–20%)
➡️ begin at the dentate line, course through the internal sphincter, travel cephalad in the inter- sphincteric space, and cross the skeletal muscle above the external sphincter to enter the ischiorectal space

4) SUBCUTANEOUS/ SUBMUCOSAL (2–3%)
➡️ begin at the dentate line and course just deep to the anoderm without any sphincter involvement

5) EXTRASPHINCTERIC
➡️ do not arise from a cryptoglandular origin and do not involve the sphincter complex
➡️these fistulas arise from:
⚫️intraabdominal source such as:
✔️diverticulitis
✔️malignancy
⚫️separate etiology:
✔️of fistulizing disease such as Crohn’s disease
✔️iatrogenic injury
✔️inappropriate drainage of a supralevator abscess

03/10/2024

The 4 F's RISK FACTORS for GALLSTONE DISEASE:
🔵Fat/obese
🔵Female
🔵Fertile/pregnant
🔵Forty years old

03/10/2024

🙏🏻❤️

03/10/2024

Excision biopsy of Bilateral Breast Mass (pagtanggal ng bukol sa suso/dede) under sedation done. May Go Home after the procedure. Maraming salamat po sa tiwala! God bless po! 🙏🏻

03/10/2024

Excision of an infected Olecranon Bursitis done. May Go Home after the procedure. Maraming salamat po sa tiwala! God bless po! 🙏🏻

02/10/2024

GALLBLADDER STONE (BATO) FREE! 3-Port Laparoscopic Cholecystectomy (pagtanggal ng Gallbladder) done for Chronic Calculous Cholecystitis (Bato sa Gallbladder na maga). May Go Home the next day after the procedure. Maraming salamat po sa tiwala! God Bless po! 🙏🏻

02/10/2024

Core Needle Biopsy of Breast Mass (pagkuha ng laman ng bukol sa suso/dede) done. May Go Home after the procedure. Maraming salamat po sa tiwala! God bless po! 🙏🏻

01/10/2024

A beautiful reminder 🙏🏻❤️

30/09/2024

Thank you so much Philippine Society of Oncologist! 🇵🇭🙏🏻

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30/09/2024

Sigmoidectomy (pagtanggal ng bituka/Sigmoid) done for Sigmoid Adenocarcinoma (kanser sa bituka/Sigmoid). Maraming salamat po tiwala! God bless po! 🙏🏻

29/09/2024

Sunday Hernioplasty (Hernia Repair with Mesh) done for Indirect Inguinal Hernia (Luslos sa singit). May Go Home the next day after the procedure. Maraming salamat po sa tiwala! God bless po! 🙏🏻