Overall
Diagnosis
Treatment
Overall
Fistula is an abnormal communication between two organ or blood vessels that don’t normally connect. They can develop any where, between vagina and vesical, intestine and the skin, naval and gut, neck and throat, most common around the anus. Infection, inflammation can also cause a form of fistula..
ANAL FISTULA is an abnormal communication or connection or passageway between anal canal and rectum with perianal skin. Many opening seen externally that is in the perianal skin but internally single opening present. Anal fistulas have many causes but most common cause is anorectal abscess. That’s why treatment focus on control of infection and stool continence.
TYPE
- Internsphincteric
- Trans-sphincteric
- Supralevator
- Subcutaneous
- Submucous
- Low anal
- High anal
- pelvirectal
CAUSES
- Anal gland infection
- Tuberculosis
- Ulcerative colitis
- Crohn’s Disease
- Colloid Carcinoma of rectum
- Diabetes
- Anal fissure abscess
- AIDS
- Schistosomiasis
- Lymphogranuloma venereum
SYMPTOMS
- Opening present on the skin, and puss discharge through this opening
- Pain and swelling around the anal area
- Puss discharge around the anal opening
- External opening may be single / multiple
- Discharge blood
- High grade Fever with chill and rigors
- Redness, sureness, itching around the anal opening
- Goodsall’s rule
- Pain when passing stool
OTHER SYMPTOMS
- Diarrhea
- Vomiting
- Less appetite
- Sleeplessnes
Diagnosis
INVESTIGATION
- Doctor diagnosis the fistula when he or she look for an opening on the skin
- Through this opening discharging the puss
- Endorectal ultrasonography
- MRI
Treatment
MEDICAL
- Antibiotics for infection
- Medication for pain relief
- Fistulotomy
Advantages:
- Least chances of recurrence
- Easly procedure
- Minor degree of incontinence
SURGICAL
- Fistulectomy
- Fistulectomy with or without colostomy
- Use of seton or medicated thread
