Fistula in Ano
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Is a chronic abnormal communication lined by degree of granulation tissues which runs outward from mucosal lumen.
Risk factors
- Previous perianal abscess formation
- Crohn’s disease
- Diabetes mellitus
- Tuberculosis
- Trauma
- Radiotherapy
- Immunosuppression-HIV, malignancy
Classifications of fistula in ano
- Intersphincteric
- Suprasphincteric
- Transphincteric
- Extra sphincteric
Clinical presentation
- Purulent or bloody discharges
- Pruritis ani
- History of anorectal abscess
Investigations
- Fistulography
- Endoanal USS
- Pelvic MRI-gold standard
- Surgical Treatment options
- Fistulotomy, Fistulectomy, Seton, Fibrin glue, anal fistula plug, Advancement flap