DOI: http://dx.doi.org/10.18203/2349-2902.isj20210380

Nigam’s pinch test to locate a chronic deep seated small perianal abscess

Vinod Kumar Nigam, Siddharth Nigam

Abstract


Background: Nigam’s pinch test (NPT) is for localization of chronic perianal abscess and incision over it.

Methods: A description of Nigam’s pinch test and demographics are presented.

Results: 20 cases of chronic deep seated perianal abscess were treated with the help of Nigam’s pinch test at Max Hospital, Gurgaon from August 2013 to August 2020. All incisions were directly made over the abscess and in no case a second incision was required. No recurrence and fistula formation occurred.

Conclusions: Chronic deep seated perianal abscess usually has no signs except deep pain in perianal area or pain while passing stool. In such cases, there is no visible or palpable swelling, oedema or redness. Sometimes, it becomes difficult to put incision on the right site and more than one incisions are applied. Nigam’s pinch test helps in localization of small deep perianal abscess and correct site of application of incision avoiding multiple incisions. Nigam’s pinch test avoids post operative complications, specially recurrence and fistula-in-ano formation.


Keywords


Fistula-in-ano, Incision, Nigam’s pinch test, Perianal abscess, Recurrence

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References


Milligan ETC. The surgical anatomy and disorders of the perianal space. Proc R Soc Med. 1943;36(7):365-78.

Chio YS, Kim DS, Lee DH, Lee JB, Lee EJ, Lee SD. Clinical characteristics and incidence of perianal disease in patients with ulcerative colitis. Ann Coloproctol. 2018;34(3):138-43.

Sahnan K, Adegbola SO, Tozer PJ, Watfah J, Phillips RK. Perianal abscess. BMJ. 2017;356:J475.

Sigmon DF, Emmanuel B, Tuma F. Perianal abscess in: Stat Pearls. Available at https://www.ncbi.nlm.nih.gov/books/NBK459167/. Accessed on 20 September 2020.

Parks AG. Pathogenesis and treatment of fistula-in-ano. Br Med J. 1961;1:463-9.

Eisenhammer S. The internal anal sphincter and the anorectal abscess. Surg Cynauol. 1956;103:501-6.

Whiteford MH: Perianal abscess/fistula disease. Clin Colon Rectal Surg. 2007;20(2):102-9.

Parks AG, Morson BC. The pathogenesis of fistula-in-ano. J Sagepule Proctology. 1962;55:76-85.

Anorectal abscess-risk factors-management teach me surgery. Available at https://teachmesurgery.com/general/anorectal/abscess/. Accessed on 20 September 2020.

Adamo K, Sandblom G, Brannstrom F, Strigard K. Prevalence and recurrence rate of perianal abscess-a population based study Sweden 1997-2009. Int J Colorectal Dis. 2016;31(3):669-73.

Read DR, Abcarian H. A prospective survey of 474 patients with anorectal abscess. Dis Colon Rectum. 1979; 22(8):566-8.

Sahnan K, Adegbola SO, Tozer J, Watfah J, KS Phillips. Perianal abscess. BMJ. 2017:356.

Bullard KM, Rothenbreger DA. Colon, rectum, and anus. chapter 28, Schwartz’s Principles of Surgery. 2005:1107.

Chabrot CM, Prasad ML, Abcarian H. Recurrent anorectal abscesses. Dis Colon Rectum. 1983;26:105.

Parks AG, Thompson JPS. Anal disease. Br Med J. 1983;2:537.

Sigmon DF, Emmanuel B, Tuma F. Perianal Abscess. Stat Pearls Publishing. 2000.

Gajendran M, Loganath P, Calinella AP, Hashash JG. A comprehensive review and update on Crohn’s disease. Dis Mon. 2018;64(2):20-57.