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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.
In some types of fistulae, a seton may be tied with more tension and tightened periodically. In this case, the seton loop will slowly cut through tissue inside the loop while scarring behind the loop, essentially "pulling out" the fistula without surgery. This is the Kshar-Sutra method mentioned by Sushruta in ancient Indian surgical practice.
The median time to definitive repair from fistula onset was 6 months (range 1 day to 28 months). The 6-month time course is commonly utilized by groups with significant experience treating fistulas, owing to the trend in encountering a less hostile abdomen than in the early phases. [ 4 ]
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 ...
A fistulotomy is the surgical opening of a fistulous tract. [1] They can be performed by excision of the tract and surrounding tissue, simple division of the tract, or gradual division and assisted drainage of the tract in a seton; a cord passed through the tract in a loop that is slowly tightened over a period of days or weeks.
Surgically created AV fistulas work effectively because they: Have high volume flow rates (as blood takes the path of least resistance; it prefers the (low resistance) AV fistula over traversing (high resistance) capillary beds). Use native blood vessels, which, when compared to synthetic grafts, [5] are less likely to develop stenoses and fail.
The first symptoms of kidney failure are silent. Failing kidneys can’t remove extra fluid from the body, nor can they filter molecules like urea, which can be toxic in high dosages, from the blood.
Before the person undergoes surgery, treatment and evaluation are needed for conditions including anemia, malnutrition, and malaria. Quality treatment in low-resource settings are possible (as in the cases of Nigeria and Ethiopia). [16] Treatment is available through reconstructive surgery. [53] Primary fistula repair has a 91% success rate. [46]