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The management of convoluted anal fistula remains a test for specialists and a baffling issue for patients. Treatment expects to cure the condition, with seepage of the related contaminated organ abscess and annihilation of the fistula tract. The greater part of perianal diseases are either idiopathic or crypto-glandular in inception. All techniques for fistula repair depend on the disposal of the fistula interior opening to the anal gland. Anorectal abscess and the fistula that it may bring about, are long-term processes, initially portrayed toward the start of the recorded medical history, as a component of the ''Corpus Hippocraticum'' in a treatise termed ''On Fistulae''.
The four main classes of fistulas are: 1) Intersphincteric 2) Transsphincteric 3) Suprasphincteric 4) Extrasphincter, The most regular giving grumblings of patients a anal fistula are swelling, agony and release. The previous two manifestations are normally connected with a abscess, when the outside or optional opening has shut or has neglected to create Anal fistula may be mistaken for suppurative hidradenitis and pilonidal sinus and the specialist should be mindful so as to make the right determination.
A few types of setons used are the Ayurveda-medicated thread, braided sutures, thread, rubber band, Penrose drains, and cable tie seton, Seton material should be non-absorbable, from non-slippage material, comfortable and least irritant for the patient. Sphincter-sparing procedures are the standard treatment of anal fistula. The search for the effective treatments, not compromising continence has led to the development of the following techniques: 1) Anal fistula plug 2) Ligation of the intersphincteric fistula tract (LIFT) 3) Fibrin glue 4) VAAFT
The prevalence of anal abscesses in the general population is probably much higher than seen in clinical practice since the majority of patients with symptoms referable to the anorectum do not seek medical attention. It is estimated that there are approximately 260,000 cases per year in the China. The mean age for presentation of anal abscess and fistula disease is 40 years (range 20 to 60).Adult males are twice as likely to develop an abscess and/or fistula compared with women.