An anal fistula is a tube that forms under the skin and connects the inside of the rectum or anus (internal hole) with the outside (external hole). It generally appears as a result of a wound, an injury 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 tumour, diabetes, anal sex, trauma, and anal foreign bodies.
The most common symptoms are anal pain and presence of pus or a foul-smelling discharge. Sometimes it is practically asymptomatic or only produces mild itching, stinging or mild discomfort.
The diagnosis is clinical, reached through a thorough medical history and a physical examination.
Treatment is based on reducing pain and antibiotic therapy to treat the infection. The only effective treatment to prevent recurrences 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
