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Encyclopedia > Anal fistula
Anal fistula
Classification & external resources
ICD-10 K60.3
ICD-9 565.1

An anal fistula is an abnormal infection that grows a second head between the epithelialised surface of the anal canal and (usually) the perianal skin. (See definition of a fistula). The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // K00-K93 - Diseases of the digestive system (K00-K14) Diseases of oral cavity, salivary glands and jaws (K00) Disorders of tooth development and eruption (K01) Embedded and impacted teeth (K02) Dental caries (K03) Other diseases of hard tissues of teeth (K04) Diseases of pulp and periapical tissues (K040) Pulpitis (K05... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Anal can mean: Anus, the external opening of the rectum Anal retentive, a person overly uptight or distressed over ordinarily minor problems Anal sex, anal sexual intercourse This is a disambiguation page, a list of pages that otherwise might share the same title. ... In medicine, a fistula (pl. ... In zootomy, epithelium is a tissue composed of a layer of cells. ... The anal canal is the terminal part of the large intestine. ... In medicine, a fistula (pl. ...


Anal fistulae originate from the anal glands, which are located between the two layers of the anal sphincters and which drain into the anal canal. If the outlet of these glands becomes blocked, an abscess can form which can eventually point to the skin surface. The tract formed by this process is the fistula. Illustration showing the location of the anal glands in a typical dog. ... Male Anatomy The anus, in anatomy, is the external opening of the rectum. ... The anal canal is the terminal part of the large intestine. ... For the death metal band, see Abscess (band). ... Tract may be a reference to: tract (anatomy), a bundle of nerve fibers following a path through the brain, or a collection of related anatomic structures (e. ...


Abscesses can recur if the fistula seals over, allowing the accumulation of pus. It then points to the surface again, and the process repeats. For the UK punk rock band, see P*U*S. PUS is also the IATA code for Gimhae International Airport. ...


Anal fistulas cannot harm and they often do not hurt, but they can be irritating because of the pus-drain. Surgery is not necessary, but many find fistula to be a source of discomfort.

Contents

Symptoms

Anal fistulae can present with many different symptoms:

  • Pain
  • Discharge - either bloody or purulent
  • Pruritus ani - itching
  • Systemic symptoms if abscess becomes infected

Pus is a whitish-yellow or yellow substance that can be found in regions of bacterial infection, including superficial infections, such as pimples. ... Pruritus ani is a medical term which refers to persistent itching of the anus (and in Latin means literally the same thing). ...

Diagnosis

Diagnosis is by examination, either in an outpatient setting or under anaesthesia (referred to as EUA - Examination Under Anaesthesia). The examination can be an anoscopy. A hospital today is an institution for professional health care provided in part by physicians and nurses. ... Anesthesia (AE), also anaesthesia (BE), is the process of blocking the perception of pain and other sensations. ... An anoscopy is an examination using a small, rigid speculum (anoscope) inserted a few inches into to the anus in order to evaluate problems of the anal canal. ...


Possible findings:

  • The opening of the fistula onto the skin may be seen
  • The area may be painful on examination
  • There may be redness
  • An area of induration may be felt - thickening due to chronic infection
  • A discharge may be seen
  • It may be possible to explore the fistula using a fistula probe (a narrow instrument) and in this way it may be possible to find both openings of the fistula

Induration (indoo rāshən, -dyoo-), a noun, means, in terms of pathology, (a) hardening of an area of the body as a reaction to inflammation, hyperemia, or neoplastic infiltration, or (b) an area or part of the body that has undergone such a reaction. ...

Treatment

There are several stages to treating an anal fistula:


Treating active infection

Some patients will have active infection when they present with a fistula, and this requires clearing up before definitive treatment can be decided. An infection is the detrimental colonization of a host organism by a foreign species. ...


Antibiotics can be used as with other infections, but the best way of healing infection is to prevent the buildup of pus in the fistula, which leads to abscess formation. This can be done with a seton - a length of suture material looped through the fistula which keeps it open and allows pus to drain out. In this situation, the seton is referred to as a draining seton. An antibiotic is a drug that kills or slows the growth of bacteria. ... A seton or seton stitch is a medical term for a procedure used to aid the healing of fistulae. ... For other uses, see Suture (disambiguation). ... For the UK punk rock band, see P*U*S. PUS is also the IATA code for Gimhae International Airport. ... A seton or seton stitch is a medical term for a procedure used to aid the healing of fistulae. ...


Definitive Treatment

Definitive treatment of a fistula aims to stop it recurring. Treatment depends on where the fistula lies, and which parts of the anal sphincter it crosses. Male Anatomy The anus, in anatomy, is the external opening of the rectum. ...


There are several options:

  • Doing nothing - a drainage seton can be left in place long-term to prevent problems. This is the safest option although it does not definitively cure the fistula.
  • Conversion to a cutting seton - this involves a similar process to a draining seton but the suture is tied tightly. This gradually cuts through the muscle and skin involved, leaving behind a small area of scarring. This cures the fistula in most cases, but can cause incontinence in a small number of cases, mainly of flatus (wind).
  • Lay-open of fistula-in-ano - this option involves an operation to cut the fistula open and let it heal naturally. This cures the fistula but leaves behind a scar, and can cause problems with incontinence. This option is not suitable for complex fistulae, or those that cross the entire anal sphincter.
  • Fibrin glue injection is a method explored in recent years, with variable success. It involves injecting the fistula with a biodegradable glue which should, in theory, close the fistula from the inside out, and let it heal naturally. This method is perhaps best tried before all others since, if successful, it avoids the risk of incontinence, and creates minimal stress for the patient.
  • Fistula plug is an "advanced" version of the fibrin glue method. It involves "plugging" the fistula with a "plug" made of porcine small intestine submucosa (sterile, biodegradable), fixing the plug from the inside of the anus with suture, and, again, letting the fistula heal "naturally" from the inside out. According to some sources, the success rate with this method is as high as 80%.
  • Endorectal advancement flap is a procedure in which the internal opening of the fistula is identified and a flap of mucosal tissue is cut around the opening. The flap is lifted to expose the fistula, which is then cleaned and the internal opening is sewn shut. After cutting the end of the flap on which the internal opening was, the flap is pulled down over the sewn internal opening and sutured in place. The external opening is cleaned and sutured. Success rates are variable and high recurrence rates are directly related to previous attempts to correct the fistula.
  • Anal Fistula Plug is a recently developed method known as AFP. This treatment requires placement and fixing of a plug in the anal fistula by a special technique. The plug is made of highly sophisticated absorbent material; it provides a scaffold over which body’s collagen gets deposited and closes the fistula. Comparative studies have shown this method to be very effective. One advantage of this method is that it involves no cutting, so there is no post operative wound and pain. AFP plugs can sometimes be inserted under local anesthesia. This method can be used successfully to treat high fistula without colostomy. It does not carry any risk of bowel incontinence. As opposed to the staged operations, which may require multiple hospitalizations, AFP requires hospitalization for only about 24 hours. The success rate of AFP is better than the other procedures. AFP was approved for clinical use by the FDA in May 2005 and hundreds of procedures have been done since then.

A scar results from the biologic process of wound repair in the skin and other tissues of the body. ... Fecal incontinence is the loss of regular control of the bowels. ... Flatus is a semi-retired webcomic featured on The Double S webpage (www. ... For other uses, see Wind (disambiguation). ... Fecal incontinence is the loss of regular control of the bowels. ... Male Anatomy The anus, in anatomy, is the external opening of the rectum. ... The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ...

External links

http://www.fistulacure.com This site provide good information about Anal Fistulas and it's treatment. Hematemesis or haematemesis is the vomiting of fresh red blood. ... In medicine, melena or melaena refers to the black, tarry feces that are associated with gastrointestinal hemorrhage. ... Gastrointestinal bleeding describes every form of hemorrhage (blood loss) in the gastrointestinal tract, from the pharynx to the rectum. ... Endoscopic image of a posterior wall duodenal ulcer with a clean base, which is a common cause of upper GI hemorrhage. ... Lower gastrointestinal bleeding refers to any form of bleeding in the Lower gastrointestinal tract. ...



 
 

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