Suggested Pre-Referral Evaluation and Management Guidelines
Referral is indicated if:
patient has perirectal pain and/or palpable induration consistent with an abscess. Patients with an acute abscess should be evaluated and treated in the emergency department prior to being referred to clinic. If the abscess spontaneously ruptures and drains, referral should still be made as the cavity may not be completely drained. 50% of such patients will go on to develop a fistula.
patient has persistent and/or recurrent rectal fistula characterized by drainage, skin excoriation, and pain. External opening can generally be found on the perineum.
Suggested Additional Test/Management Prior to Specialty Visit
Colonoscopy should be performed to assess for underlying inflammatory bowel disease if patient has not been diagnosed. This need not be done prior to the clinic visit.
If colonoscopy and biopsy are performed outside of the UMHS system, reports should be mailed or faxed at or before the time of the clinic visit. Receiving these prior to the clinic visit is preferable.
Patient Education/Information (includes preps)
Dictated by condition. Patients with an acute abscess should be sent to the emergency department for immediate care.
Patients with treated, chronic, or recurrent problems will be seen within 2-4 weeks.
How to Get Results to Consultant
UMHS Patients: See MiChart
Reports and/or medical records can be faxed to 734-232-6189
CDs can be hand-carried to the appointment
Reports, medical records, CDs, and pathology slides can be mailed to:
Division of Colorectal Surgery
Attention: Jain Carver
1500 East Medical Center Drive, SPC 5343
Ann Arbor, MI 48109-5343