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Anal Fistula

An abnormal duct or passage resulting from injury, disease, or a congenital disorder that connects an abscess, cavity, or hollow organ to the body surface or to another hollow organ.

Location of fistula:

Fistulas can develop in various parts of the body. Some are described below-
1. Diseases of the eye, adnexa, ear, and mastoid process
  • Lacrimal fistula 
  • Mastoid fistula
  • Craniosinus fistula: between the intracranial space and a paranasal sinus
  • Labyrinthine fistula
  • Perilymph fistula: tear between the membranes between the middle and inner ears
  • Preauricular fistula
  • Preauricular fistula: usually on the top of the cristae helicis ears
2. Diseases of the circulatory system
  • Coronary arteriovenous fistula, acquired
  • Arteriovenous fistula of pulmonary vessels
  • Pulmonary arteriovenous fistula: between an artery and vein of the lungs, resulting in shunting of blood. This results in improperly oxygenated blood.
  • Cerebral arteriovenous fistula, acquired
  • Arteriovenous fistula, acquired
3. Diseases of the respiratory system
  • Tracheoesophageal fistula following tracheostomy: between the breathing and the feeding tubes
4. Diseases of the digestive system
  • Duodeno Biliary Fistula
  • Fistula of salivary gland
  • Fistula of stomach and duodenum
  • Gastrocolic fistula
  • Gastrojejunocolic fistula - after a Billroth II, a fistula forms between the transverse colon and the upper jejunum (which, post Billroth II, is attached to the remainder of the stomach). Fecal matter passes improperly from the colon to the stomach and causes halitosis.
  • Enterocutaneous fistula: between the intestine and the skin surface, namely from the duodenum or the jejunum or the ileum. This definition excludes the fistulas arising from the
  • Fistula of appendix         
  • Anal fistula
  • Anorectal fistula: connecting the rectum or other anorectal area to the skin surface. This results in abnormal discharge of feces through an opening other than the anus. Also called fistula-in-ano.
  • Fistula of intestine
  • Enteroenteral fistula: between two parts of the intestine
  • Fistula of gallbladder
  • Fistula of bile duct
  • Biliary fistula: connecting the bile ducts to the skin surface, often caused by gallbladder surgery
  • Pancreatic fistula: between the pancreas and the exterior via the abdominal wall
5. Diseases of the musculoskeletal system and connective tissue
  • Fistula of joint
6. Diseases of the urogenital system
  • Vesicointestinal fistula
  • Urethral fistula
  • Fistulae involving female genital tract / Obstetric fistula
  • Vesicovaginal fistula: between the bladder and the vagina
  • Cervical fistula: abnormal opening in the cervix
  • Enterovaginal fistula: between the intestine and the vagina
  • Rectovaginal: between the rectum and the vagina
  • (N82.9) Female genital tract fistula, unspecified
7. Congenital malformations, deformations and chromosomal abnormalities
  • Sinus, fistula and cyst of branchial cleft
  • Congenital Preauricular fistula: A small pit in front of the ear. Also called Fistula Auris Congenita or Ear Pit
  • Congenital absence, atresia and stenosis of rectum with fistula
  • Congenital absence, atresia and stenosis of anus with fistula
  • Congenital fistula of rectum and anus
  • Congenital fistulae between uterus and digestive and urinary tracts
  • Congenital rectovaginal fistula
8. External causes
  • Traumatic arteriovenous fistula
  • Persistent postoperative fistula
Types of fistulas:

Various types of fistulas include-
1.Blind: with only one open end
2.Complete: with both external and internal openings
3.Incomplete: a fistula with an external skin opening, which does not connect to any   internal organ
Although most fistulas are in forms of a tube, some can also have multiple branches.

Cause:

1.Diseases- some diseases are responsible for the development of fistula. Like Crohn's disease, Ulcerative colitis, are responsible.
2.Trauma- injury, obstetrics fistula etc.
3.Medical treatment- constant radiological exposure leading to development of a fistula or fistulae.

Treatment:

1.In severe cases, surgery is advisable to the patient along with the therapeutics.
2.Homoeopathy -  The patients of fistula are usually advised surgery for their problem. But this is just a temporary solution as invariably the fistulas recur. Also a lot of complications can occur due to surgery. Homoeopathy helps in treating complications and preventing the recurrence. The medicines are selected based on the case analysis and individualizing the case.

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