Fistula is abnormal tunnel of pus formation near anal area with infection with pus discharge
There can be one or more Small external opening on perianal skin & internal opening inside the anal canal.
Symptoms & Diagnosis
Foul smelling Pus discharge mixed with blood Pain over hole or External Opening on Skin with redness Occasional Fever & repeated infection History of Perianal Abscess
Assessment of patient as per following
- ● Digital Rectal Examination with Proctoscopy
- ● Fistulous tract & Opening can be felt with fingers
- ● Ultrasound & MRI Fistulogram - Best investigation for Grading & Diagnosis of Fistula in Ano
Causes
- ● Perianal Abscess (30 - 40 %)
- ● Tuberculosis
- ● Diabetes patient
- ● Chronic Fissure In Ano
- ● Crohns Disease
- ● Infection in Genital area in females ( Bartholin gland abscess )
- ● Secondary to radiation, Trauma
- ● Cancer
- ● Diverticulitis
Fistula Surgery
- ● Fistulectomy - gold standard treatment & it provides lowest recurrence rates
- ● Fistulotomy (92 - 96% success rates )
- ● LIFT - Ligation of intersphincteric tract
- ● Laser Assisted Fistula Closure