Anal fistula classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
Anal fistula are classified into four types based on the relationship to sphincter- intersphincteric, transsphincteric, suprasphincteric, extrasphincteric. Anal fistula are classified into two categories based on the risk factors associated- simple anal fistula and complex anal fistula. Anal fistulas are also classified according to primary tracks into two- high and low anal fistulas.
Classification
Anal fistulas are classified into the four types based on the relationship to sphincter:[1][2]
- Intersphincteric
- Transsphincteric
- Suprasphincteric
- Extrasphincteric
Anal fistulas are classified into two categories based on the risk factors associated:
- Simple anal fistula:[3]
- There are no risk factors associated with simple anal fistula.
- Treatment of simple anal fistula results in low incidence of fecal incontinence and poor wound healing.
- Complex anal fistula:[4]
- There are many risk factors associated with complex anal fistula e.g preexisting incontinence, recurrent fistula, local irradiation, chronic diarrhea, or crohn's disease.
- There are multiple tracts found in complex anal fistula and is anterior in the location in females.
Anal fistulas are classified according to the position of primary tracks:[5]
- Low fistula - In a low fistula close to the skin and the track passes through few or no sphincter muscle fibres.
- High fistulas- High fistula passes through multiple muscle fibers.
References
- ↑ Parks AG, Gordon PH, Hardcastle JD (1976). "A classification of fistula-in-ano". Br J Surg. 63 (1): 1–12. PMID 1267867.
- ↑ Seow-Choen F, Nicholls RJ (1992). "Anal fistula". Br J Surg. 79 (3): 197–205. PMID 1555083.
- ↑ Sangwan YP, Rosen L, Riether RD, Stasik JJ, Sheets JA, Khubchandani IT (1994). "Is simple fistula-in-ano simple?". Dis. Colon Rectum. 37 (9): 885–9. PMID 8076487.
- ↑ Fazio VW (1987). "Complex anal fistulae". Gastroenterol. Clin. North Am. 16 (1): 93–114. PMID 3298058.
- ↑ "Management of anal fistula | The BMJ".