Anal fistula overview
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Anal fistula Microchapters |
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Diagnosis |
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Treatment |
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Anal fistula overview On the Web |
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American Roentgen Ray Society Images of Anal fistula overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
An anal fistula is an abnormal connection between the epithelialised surface of the anal canal and (usually) the perianal skin. (See definition of a fistula).
Anal fistulae originate from the anal glands, which are located between the two layers of the anal sphincters and which drain into the anal canal. If the outlet of these glands becomes blocked, an abscess can form which can eventually point to the skin surface. The tract formed by this process is the fistula.
Abscesses can recur if the fistula seals over, allowing the accumulation of pus. It then points to the surface again, and the process repeats.
Anal fistulas per se do not generally harm and they often do not hurt, but they can be irritating because of the pus-drain; additionally, recurrent abscesses may lead to significant short term morbidity from pain, and create a nidus for systemic spread of infection.
Surgery is considered essential in the decompression of acute abscesses; repair of the fistula itself is considered an elective procedure which many patients elect to undertake due to the discomfort and inconvenience associated with a draining tract.
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Anal fistula overview from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Pharmacotherapy used in anal fistula depends upon the location and symptoms of patient. Antibiotics are used in patient with comorbities like immunosuppression, diabetes, extensive cellulitis, prosthetic devices and high risk cardiac patients. Antipyretics and analgesic for symptomatic relief of pain and fever. Treatment of underlying causes is important to treat recurrent anal fistulas.