Anal Fistulae

Question 1

What is a fistulae?

Answer 1

an abnormal connection between vessels or organs that do not usually connect

Question 2

What is an anal fistulae?

Answer 2

connection between last part of the bowel and skin around the anus

Question 3

What are RF for anal fistulae?

Answer 3

1. clogged anal glands and anal abscesses
2. Crohn’s disease
3. Radiation (cancer)
4. Trauma

Question 4

What is the presentation of anal fistulae?

Answer 4

1. Frequent anal abscesses
2. Pain and swelling around anus
3. Bloody/Foul smelling drainage (pus) – in underwear

Question 5

What investigations are used for anal fistulae?

Answer 5

• EXAMINATION:
• Opening on the skin around the anus
• Not always visible
• Anoscope / Rectoscope

Question 6

What investigations may be considered for anal fistulae?

Answer 6

EUA and MRI

Question 7

What is the surgical management for anal fistulae?

Answer 7

1. Fistulotomy

2. Seton

Question 8

What is a seton and how does it work?

Answer 8

1. piece of surgical thread that’s left in the fistula for several weeks to keep it open
2. allows it to drain and helps it heal, while avoiding the need to cut the sphincter muscles
   3, loose setons allow fistulas to drain, but do not cure them.

Question 9

How are fistulae and abscess related?

Answer 9

fistula can cause an abscess and an abscess can cause a fistula