Anal fistula
An anal fistula is an abnormal communication between two epithelial surfaces - the perianal skin and the anal or rectal lumen (1).
- this abnormal tract is lined with granulation tissue
- it may harbour chronic infection resulting in continuous or intermittent discharge through the external opening on to the skin
- soiling of underwear and skin irritation may be seen in severe cases due to faecal material passing through the tract (1)
In England, incidence of anal fistula is 18.4 per100,000/year. More common in men (twice as likely to be affected) with a peak around 40 years of age (1).
Fistulae may be complex, with several openings onto the perianal skin (2).
References:
- Simpson JA, Banerjea A, Scholefield JH. Management of anal fistula. BMJ. 2012;345:e6705
- National Institute for Health and Clinical Excellence (NICE). Bioprosthetic plug insertion for anal fistula. Interventional procedures guidance IPG662. Published September 2019
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