Anal Fistula

An anal fistula is commonly known as Fistula-in-ano as it is frequently the result of a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus or rectum. The fistula is the tunnel that structures under the skin and interfaces the stopped up infected organs to a abscess. A fistula can be available with or without an abscess and may join just to the skin of the buttocks near the anal opening. Microscopic organisms, fecal material or foreign matter can obstruct a butt-centric organ and passage into the tissue around the anul or rectum, where it might then gather in a cavity called an abscess.

Anal Fistula is classified by two categories. 1) By their location in relation to the structures comprising and surrounding the anus and rectum. on this basis, it is subclassified as perianal, ischioanal, intersphincteric and supralevator area. 2) By their relationship to parts of the anal sphincter complex: They are subclassified as intersphincteric, transsphincteric, suprasphincteric and extrasphincteric. Anorectal pain, swelling, perianal cellulitis (redness of the skin) and fever are the most common symptoms of an abscess. Occasionally, rectal bleeding or urinary symptoms, such as trouble initiating a urinary stream or painful urination, may be present.

Presently, there is no medicinal treatment accessible for this issue and surgery is quite often important to cure an anal fistula. On the off chance that the fistula is direct (including negligible sphincter muscle), a fistulotomy may be performed. The surgery may be performed in the meantime as waste of a abscess. An endoanal advancement flap is a strategy generally held for complex fistulas or for patients with an expanded potential danger for affliction incontinence from a conventional fistulotomy. Another non-sphincter dividing treatment for anal fistula is the LIFT (ligation of the intersphincteric fistula tract) strategy.

High-type deformities accounted for 26.0% of cases, intermediate 10.7%, low 57.2%, miscellaneous 4.5% and unclassified 1.8%. The most frequent deformity was male anocutaneous fistula (n = 364), followed by male rectourethral fistula (n = 333), and female anovestibular fistula (n = 241). In rectourethral fistula, the blind end of the rectum lay at or above the level of the P-C line in 40.3% of cases, at or above the M line in 39.6% and at the vicinity of the I line in 20.2%, respectively. The overall incidence of patients having one or more associated anomalies was 45.2%: 70.6% in high deformity, 60.7% in intermediate, and 31.3% in low. The rate of association of Down's syndrome with deformities without fistula (40.3%) was significantly higher than with deformities with fistula (0.3%).