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Anal fistula is a chronic abnormal communication between the anal canal and the perianal skin. [1] An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. [2] Anal fistulae commonly occur in people with a history of anal abscesses. They can form when ...
Surgical Therapy (for chronic fissures or when non-surgical therapy fails) : Anal Dilation, [8] Lateral Internal Sphincterotomy, Advancement Flaps, Fissurectomy. Anorectal Abscess and Fistula Painful swelling, [ 5 ] Redness, Pain, [ 10 ] Bloody diarrhea, [ 11 ] an opening can point to a fistula, with or without drainage [ 5 ] with itchiness.
The diagnosis of a rectovestibular fistula can be made in female newborns if the vulva is stained with meconium (the earliest form of stool in an infant). [3] The opening of the anus may be difficult to see due to its small size and position, but it may be visible as a thickening of the median perineal raphe with an obvious anal dimple.
In anatomy, a fistula (pl.: fistulas or fistulae /-l i,-l aɪ /; from Latin fistula, "tube, pipe") is an abnormal connection (i.e. tube) joining two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow organs to each other, often resulting in an abnormal flow of fluid from one space to the other.
Goodsall's rule relates the external opening (in the perianal skin) of an anal fistula to its internal opening (in the anal canal). It states that if the perianal skin opening is posterior to the transverse anal line, the fistulous tract will open into the anal canal in the midline posteriorly, sometimes taking a curvilinear course.
A rectal prolapse occurs when walls of the rectum have prolapsed to such a degree that they protrude out of the anus and are visible outside the body. [2] However, most researchers agree that there are 3 to 5 different types of rectal prolapse, depending on whether the prolapsed section is visible externally, and whether the full or only partial thickness of the rectal wall is involved.
In 1993 Matos et al. described a technique of total anal sphincter preservation in high fistula in ano, which is based on the concept of excision of intersphincteric anal gland infection through the intersphincteric approach. [3] This novel technique was also documented in Corman’s textbook of colon and rectal surgery. [4]
A CT scan is the preferred method of diagnosis; however, free air from a perforation can often be seen on plain X-ray. [2] Perforation anywhere along the gastrointestinal tract typically requires emergency surgery in the form of an exploratory laparotomy. [2] This is usually carried out along with intravenous fluids and antibiotics. [2]