Anal fistulas square measure typically common among people who have had associate degree anal symptom.Treatment is typically necessary to scale back the possibilities of infection in associate degree anal fistula, further to alleviate symptoms.
An associate degree fistula is outlined as a tiny low tunnel with an inside gap within the anal canal and an external gap within the skin close to the arsehole. Anal fistulas type once associate degree anal symptom, that is drained, doesn't heal completely.
different varieties of anal fistulas square measure classified by their location.Dr.P.S.Lubana cures as Fistula Surgeon in Indore.
In order of most common to least common, the various types include:
• Intersphincteric fistula : The track begins within the house between the inner and external anatomical sphincter muscles and opens terribly near to the anal gap.
• Transphincteric fistula : Transphincteric fistula: The track begins within the house between the inner and external anatomical sphincter muscles or within the house behind the arsehole. It then crosses the external anatomical sphincter and opens an in. or 2 outside the anal gap. These will wrap around the body in a very U form, with external openings on either side of the arsehole (called a horseshoe fistula).
• Suprasphincteric fistula : Suprasphincteric fistula: The track begins within the house between the inner and external anatomical sphincter muscles and turns upward to some extent on top of the puborectal muscle, crosses this muscle, then extends downward between the puborectal and levator cuckoo muscle and opens an in. or 2 outside the arsehole.
• Extrasphincteric fistula : Extrasphincteric fistula: The track begins at the body part or colon and extends downward, passes through the levator cuckoo muscle and opens around the arsehole. These fistulas square measure typically caused by associate degree appendiceal symptom, diverticular symptom or regional ileitis.
It is typically easy to find the external gap of associate degree anal fistula, meantime locating the inner gap are often more difficult. It is necessary to be able to notice the complete fistula for effective treatment.
People who might have expertise with revenant associate degree abscesses might have an anal fistula. The external opening of the fistula is usually red, inflamed, oozes pus, and is sometimes mixed with blood.
The location of the external gap provides a clue to a fistula's doubtless path and generally the fistula will truly be felt. However, locating its visual path often requires various tools, and often times it may not be seen until surgery.
Tools often used in diagnosis include:
• Fistula probe : associate degree instrument specially designed to be inserted through a fistula
• Anoscope : any low instrument to look at the anal canal
If a fistula is doubtless sophisticated or in associate degree uncommon place, these tools may also be used:
• Diluted thiazine dye: Injected into a fistula
• Fistulography: Injection of a contrast solution into a fistula and then X-raying it
• Magnetic resonance imaging
Tools wont to rule out alternative disorders like inflammatory bowel disease or regional ileitis include
Treatment is exquisitely performed to scale back the chance of touching intestine removal, thanks to the anal fistulas' proximity to the sphincter muscles. The best approach needs that every patient is assessed severally. Treatment of associate degree anal fistula is tried with as very little impact as attainable on the anatomical sphincter muscles.
In a fistulotomy the MD 1st probes to seek out the fistula's internal gap. Then the track is cut open and is scraped and its contents square measure flushed out, then its sides are stitch to the sides of the incision in order to lay open the fistula. A additional sophisticated fistula, such as a horseshoe fistula (where the track extends around both sides of the body and has external openings on both sides of the anus), is treated by typically egg laying open simply the phase wherever the tracts be a part of and also the remainder of the tracts square measure removed. The surgery could also be performed in additional than one stage if an oversized quantity of muscle should be cut. The surgery may have to be continual if the complete track cannot be found.
Advancement Rectal Flap
PS Luabana may core out the track and then cut a flap into the rectal wall to access and remove the fistula's internal opening then stitches the flap back down. This is typically done to scale back the quantity of musculus to be cut.
A seton (silk string or rubber band) is used to either:
• produce connective tissue around a part of the musculus before cutting it with a knife
• enable the religious leader to slowly cut all the manner through the muscle over the course of many weeks
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