Anal Fistula Flashcards

1
Q

Definition of anal fistula

A
  • Is a chronic abnormal
    communication between the epithelialized surface of the anal canal and usually the perianal skin.
    #An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus
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2
Q

Presenting complaints

A

*Intermittent perianal discharge *Perianal itching
*Pain
*Swelling
*fever

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3
Q

Causes/ risk factors of fistula

A

*HIV/AIDS
*Colorectal c a n c e r
*Other causes of immunosuppression
*Tuberculosis
*Lymphogranulomavenereum *Ulcerative colitis
*Crohn’s disease
*Trauma, foreign body *Hydradenitissuperativa

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4
Q

Examination of anal fistula

A

*Rectal examination (inspection) DRE
*Proctoscopy/ sigmoidoscopy

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5
Q

What is Goodsall’s Rule

A

*When an imaginary transverse line is drawn through the center of the anus in lithotomy position

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6
Q

Goodsall’s Rule locations of anal fistula

A

*Fistula located anteriorly within 3cm radius from the anus run a direct radial course into the anal canal
*Fistula located posteriorly and those <3cm radius anteriorly run a curvilinear course to open at the middle of the anal canal
posteriorly

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7
Q

Where is anal fistula mostly located

A

*Majority of fistula are posterior.

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8
Q

In women where is the fistula located

A

*Anterior fistula are common in women.

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9
Q

Investigations of fistula

A

*Investigation Discharge for m/c/s *Fistulogram Colonoscopy
*Barium enema
*Chest X-ray, ESR, Mantoux test MRI
Endoanal/ endorectal USS

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10
Q

Treatment of fistula

A

*Fistulotomy
*Fistulectomy
*Seton application
* Advance flap
*Fibrin glue injection
*Fistula plug
*LIFT: ligation of intersphinteric tract

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