Anal Fistula

Anal Fistula is a tiny, tubular, fibrous that extends into the anal canal from an opening located beside the anus or it is an abnormal connection between the epithelialized surface of the anal canal and perianal skin.

Or,

It is an opening at or near the anus usually into the rectum above the internal sphincter.

Causes:

• Infection.
• Develop from traumas fissures or regional enteritis.

Note: Originate from the anal glands which are located between tow layers of the anal sphincter and which drains into the anal canal. It the outlet of these glands becomes blocked, an abscess can form which can eventually point to the skin surface. The tract formed by this is the fistula.

Clinical Features:

• Pus or stool my leak constantly from the cutaneous opening.
• Passage of flatus, faeces from the vagina and bladder.
• Pain
• Discharge either bloody.
• Puritis-ani itching
• Systemic symptoms if abscess become infected.

Diagnosis:

• EUA (Examination under Anesthesia)
• Examination can be an anascopy findings
• Opening of the fistula into the skin may be seen.
• Area may be painful on examination.
• Redness
• Area of induarion may be felt-thickening due to chronic infection.
• A discharge may be seen.

Management:

1. Surgical Management
2. Nursing Management

Surgical Management:
Several stages to treating an anal fistulas,

• Treating Active infection before surgery. Antibiotic can be used with other infections, but the best way of healing infection is to prevent the build up of pus in the fistula which lead to abscess formation can be done with a seton a length of refuse material loop through the fistula which keeps it open and allows pus to drain out.