Sushruta Clinic- Multiple Fistulas
Any boil or abscess at perianal area which bursts with discharge or surgically drained is initially a Fistula. The
discharge of pus or blood may be intermittent or continuous soiling the under clothes.
1. Boil or abscess at perianal region which bursts with discharge.
2. Cryptoglandular anal infection leading to anal abscess formation which bust which discharge leading to
3. Erosion and ulceration in anal canal provide the route for bacterial infection in anal canal. The infection
spreads to pararectal spaces leading to abscess formation and development of anal Fistula.
4. Anal Fissure is the most common cause of Anal abscess.
5. Blood born infection of pararectal spaces during malaria, Typhoid, Prolong illness, Tuberculosis, lower
resistance and diabetes may couse anal abscess formation.
Clinical feature :-
Initially an abscess or boil at perianal region either to burst with discharge or inadequatly drained leads
to fistula formation. Intermetent or persistant discharge of pus or blood with pain or without pain is the prominant
feature of Anal fistula.
Types of the Fistula :-
1. Law Anal
2. High Anal
4. High Intermuscular
Treatment of Fistula :-
Treatment of fistula is surgical.
The operative treatment of Anal fistula consists of fistulectomy or fistulostomy.
Complete tubular tract of Fistula is dissected from adjascent tissues and excised. Daily dressing is done.
A probe is passed into fistulous tract which is laid open completely and dressing is done.
Operative results of anal fistula :-
An average recurrence rate of Anal fistula after adequate surgery is about 50%. The results of high Anal and
horse shoe shape fistula are not satisfactory. Recurrence and incontinance for faeces and flatus are common
complications of surgery for Anal fistula. Really in anorectal and multiple horse shoe shape anal fistula excision
of the rectum and colostomy is the choice of operation for complete eradication of disease.