Anal fistula: Difference between revisions

Revision as of 00:12, 14 July 2016

Inflammatory tract originating from infected anal gland connecting anal canal with skin
- May be intersphincteric, suprasphincteric, transsphincteric, or extrasphincteric
Goodsall's Rule
- Draw imaginary line horizontally through the anal canal
  - If external opening is anterior to this line fistula runs directly into the canal
  - If external opening is posterior to this line fistula curves to post midline of canal
Causes:
- Perianal/ischiorectal abscess, Crohn's, ulcerative colitis, malignancies, STI, anal fissures, foreign bodies, TB

Fistulous tract open: Persistent, painless, blood-stained, mucous, malodorous discharge
Fistulous tract blocked: Bouts of inflammation that are relieved by spontaneous rupture
Abscess
- Throbbing pain that is constant and worse with sitting, moving, defecation
- May be only sign of fistula
Fistulous opening
- Adjacent to anal margin suggests superficial connection (e.g. intersphincteric region)
- Distant from anal margin suggests deeper, more superior abscess

Authors:

@@ Line 7: / Line 7: @@
 ***If external opening is posterior to this line fistula curves to post midline of canal
 *Causes:
-**Perianal/ischiorectal abscess, Crohn, UC, malignancies, STI, fissures, FBs, TB
+**Perianal/ischiorectal abscess, [[Crohn's]], [[ulcerative colitis]], malignancies, [[STI]], [[anal fissures]], foreign bodies, [[TB]]
 ==Clinical Features==
 *Fistulous tract open: Persistent, painless, blood-stained, mucous, malodorous discharge