Fistula is an abnormal connection between the exterior and a hollow viscus or between two hollow viscera. Fistula in ano is track, lined by granulation tissue that connects deeply in the anal canal or rectum and superficially on the skin around the anus.
Signs and symptoms
- Skin excoriation
- Perianal discharge
- External opening
A fistula in ano is a track that develops from the inner lining of the anus through the tissues that surround the anal canal. (The anal canal is the last 3-4 cm of the intestine, and ends at the anus.) The track opens into the skin near the anus. The track gets repeatedly infected by bacteria in the stool, becomes painful, and discharges pus. A high fistula takes a long path and goes through an important muscle, the levator ani. Fistulas are treated by surgically removing the entire false track, and the surrounding tissues.
Ordinary fistulae need laying the track open and formation of a groove which will heal from the bottom of the groove.Occasionally a high fistula may need a two stage operation ??? I stage of laying open as far as possible then inserting a Seton’s suture ??? II stage laying the rest of the tract open.