Dr.Kumargurubaran

Billroth Hospitals, B, block 43, Lakshmi Talkies Rd, Shenoy Nagar, Chennai, Tamil Nadu 600030

+919360391740

gastrosurgeondrkumar@gmail.com

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Anal Fistula/ Fistula In Ano

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Fistula in an/Anal Fistula (also known as POWTHIRAM in Tamil)is a tract or a tunnel lined by epithelium connecting the skin around the anus and the mucous membrane inside the anus.

In simple words fistula is a tract or tunnel going from an

external opening in the skin around the anus, transversing under the skin and piercing the sphincter muscles, and going into the anus and opening into an internal opening inside the anal canal. The anal fistula is an infected tunnel between the skin and the anus.

Causes Of Anal Fistula

The most frequent cause of an anal fistula is an anal gland that has become infected with pus (abscess), Some diseases, including Crohn’s disease, can also cause a fistula. Or it could occur following cancer radiation treatment, Anal fistulas can also be brought on by surgery and anal canal injury.

Types Of Anal Fistula

Simple Fistula-When the fistula has no multiple branches and a straight tract.

Complex Fistula-When there are multiple branches and multiple openings.

Low anal Fistula-When the internal opening is below the dentate line i.e. The anal fistula opens lower into the anal canal.

High anal Fistula-When the internal opening is above the dentate line i.e. The fistula opens higher up into the anal canal.

Multiple anal Fistula-When there are multiple anal fistula due to inadequate or late treatment of simple fistula or secondary to tuberculosis or inflammatory bowel disease or rarely gonococcal infections.

Intersphincteric Fistula-Where the fistula transverses the intersphincteric plane.

Trans sphincteric Fistula-Where the fistula passes through the sphincters is called trans sphincteric fistula.

Internal Fistula-Mostly when there is no obvious external opening and the fistula is inside the anal verge,it is called internal fistula.

Fissure Fistula-When a chronic fissure erode into the tissues resulting in fissure fistula.

Symptoms Of Anal Fistula

Usually presents with a swelling in the skin outside the anus which bursts discharging pus and persistent wound/hole remains discharging pushpin and swelling around the anal area, Fever and chills, Feeling tired and sick, Redness, soreness, or itching of the skin around the anal opening, Us drainage near the anal opening, Bleeding along with the stool

Diagnosis Of Anal Fistula

Anal   Fistula   is  diagnosed    by      Physical examination,   MRI Fistulogram,Fistulography.

Treatment Options Of Anal Fistula Fistulectomy

Many times the treatment of fistula involves the excision of the

whole tract. This is known as fistulectomy. This can be done in simple fistula

Fistulotomy:  Sometimes the fistula tract is laid open instead of excision of the whole tract. This is called fistulotomy.

Seton Knotting : In cases of high fistula many times it may not be possible to excise or remove the whole tract in single surgery. So in cases of high fistula the thread known as seton may be inserted into the higher part of the fistula and the lower part of the fistula may be removed in stage one surgery. After two months the seton with the remaining fistula may be removed in the second stage.

Lift Procedure

It stands for ligation of intersphincteric fistula. It entails closing (ligating) the portion of the fistula that travels between the two sphincter muscles (intersphincteric),typically with stitches before the surgeon may removes the entire fistula tract from this space or scrape out the infected tissue inside. This procedure typically happens after a seton knotting procedure.

Video-Assisted Fistula Treatment

In this telescope is passed through the fistula and the inner lining is cauterized and the internal opening is closed.

Laser Treatment Of Fistula

Laser can be used for the treatment of fistula. Laser can be

used for removing fistula -fistulectomy. Sometimes the laser can be used to cauterize the inner lining of the fistula. Laser is associated with faster recovery.

DR.KUMARAGURUBARAN has huge experience in LASER TREATMENT FOR FISTULA and is an expert in FISTULA TREATMENT AND FISTULA SURGERY and can be considered one of the Best Doctor for FISTULA TREATMENT AND SURGERY.

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