An anal fistula is a passage that forms under the skin and connects the inside of the rectum or anus (internal opening) to the outside (external opening). It usually appears as a result of a wound, a lesion produced during surgery or an infection in the anal area.
Risk factors for developing it include Crohn's disease and ulcerative colitis, radiotherapy treatment, some infections, anorectal tumor, diabetes, anal sex, trauma and anal foreign bodies.
The most frequent symptoms are anal pain and the presence of pus or a foul-smelling discharge. Sometimes it is practically asymptomatic or only causes mild discomfort such as itching or stinging.
Diagnosis is clinical by detailed clinical history and physical examination.
Treatment is based on pain reduction and antibiotic therapy to treat the infection. The only effective treatment to avoid recurrence is surgery.
- Elizabeth Breen, Ronald Bleday. Anorectal fistula: Clinical manifestations, diagnosis, and management principles. UpToDate. Jun 08, 2015.
- Abcarian H. Anorectal infection: Abscess-fistula. Clinics in colon and rectal surgery 2011. 24:14.
- Kurer MA, Davey C, Khan S, Chintapatla S. Colorectal foreign bodies: a systematic review. Colorectal Dis 2010; 12:851.
- Anal abscess/fistula. American Society of Colon & Rectal Surgeons. 2008. www.fascrs.org/patients/conditions/anal_abscess_fistula/ (Accessed on April 25, 2011).
- María García Ávila, Eva María Aguilar Blanco, Ángel Blanco Bravo. Urgencias en proctología. Manual de protocolos y actuación en urgencias. Hospital Virgen de la Salud, Complejo Hospitalario de Toledo. Tercera edición. 2010. 485:490
- Rizwan Ahmed, Susan L. Gearhart. Diverticulosis y trastornos anorrectales frecuentes. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición. 1971:1978
- E. Moreno-Osset, M. Mínguez Pérez, A. Benages Martínez. Enfermedades del recto y del ano. Farreras Rozman. Medicina Interna. Volumen 2. 12º edición. 199:200
