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Fistula-in-Ano
 

In medicine, a fistula (pl. fistulas or fistulae) is an abnormal connection or passageway between organs or vessels that normally do not connect.

Location of fistulas

Fistulas can develop in various parts of the body, including (sorted by International Statistical Classification of Diseases and Related Health Problems):

H: Diseases of the eye, adnexa, ear, and mastoid process

I: Diseases of the circulatory system

J: Diseases of the respiratory system

K: Diseases of the digestive system

M: Diseases of the musculoskeletal system and connective tissue

  • (M25.1) Fistula of joint

N: Diseases of the genitourinary system

Q: Congenital malformations, deformations and chromosomal abnormalities

T: External causes

Types of fistulas

Various types of fistulas include:

  • Blind: with only one open end
  • Complete: with both external and internal openings
  • Incomplete: a fistula with an external skin opening, which does not connect to any internal organ

Although most fistulas are in forms of a tube, some can also have multiple branches.

Causes

Various causes of fistula are:

  • Medical treatment: Complications from gallbladder surgery can lead to biliary fistula. Radiation therapy can lead to vesicovaginal fistula.

  • Trauma: Head trauma can lead to perilymph fistulas, whereas trauma to other parts of the body can cause arteriovenous fistulas. Obstructed labor can lead to vesicovaginal and rectovaginal fistulas. Vesicovaginal and rectovaginal fistulas may also be caused by rape, in particular gang rape, as evidenced by the abnormally high number of women in conflict areas, such as that of the Second Congo War, who have suffered fistulae.

Treatment

Treatment for fistulae varies depending on the cause and extent of the fistula, but often involves surgical intervention combined with antibiotic therapy.

Typically the first step in treating a fistula is an examination by a doctor to determine the extent and "path" that the fistula takes through the tissue.

Surgery is often required to assure adequate drainage of the fistula (so that pus may escape without forming an abscess). Various surgical procedures are commonly used, most commonly fistulotomy, placement of a seton (a cord that is passed through the path of the fistula to keep it open for draining), or an endorectal flap procedure (where healthy tissue is pulled over the internal side of the fistula to keep feces or other material from reinfecting the channel). Treatments involving filling the fistula with fibrin glue or plugging it with plugs made of porcine small intestine submucosa have also been explored in recent years, with variable success. Surgery for anorectal fistulae is not without side effects, including recurrence, reinfection, and incontinence.

It is important to note that surgical treatment of a fistula without diagnosis or management of the underlying condition, if any, is not recommended. For example, surgical treatment of fistulae in Crohn's disease can be effective, but if the Crohn's disease itself is not treated, the rate of recurrence of fistula is very high (well above 50%).

See also

External links

Diseases

Fistel | Fistule | Fistel | Fistel | Fístula

 

This article is licensed under the GNU Free Documentation License. It uses material from the "Fistula".

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