What makes a fistula complex?

A fistula-in-ano is termed “complex” when the track crosses > 30%-50% of the external sphincter (high-transsphincteric, suprasphincteric and extrasphincteric), is anterior in a female, is recurrent, has multiple tracks, or the patient has preexisting incontinence, local irradiation or Crohn’s disease[1-4].

How do you treat a perianal fistula complex?

Surgical therapy is the main method used to treat anal fistula. The best treatment criterion is to eradicate the infected lesion, ensure sufficient drainage, and promote the closure of the fistula, while minimizing damage to the anal sphincter (5).

What is a horseshoe fistula?

Horse-shoe fistulas usually have an internal opening in the posterior midline and extend anteriorly and laterally to one or both ischiorectal spaces by way of the deep potential space. The “Śambukāvarta Bhagandara” described by Suśruta can be correlated with the horse-shoe type of fistula.

Can fistulas cause back pain?

Spinal dural fistulas may not cause any symptoms until they enlarge or cause swelling in the spinal cord. When symptoms do appear, they are diverse: Lower back pain.

How do you treat a horseshoe fistula?

As in other high anal fistulas, horseshoe-shaped anal fistulas can be operatively treated implementing a fistulectomy combined with any of the above-mentioned forms of closure of the internal fistula opening, with good success rates and acceptable postoperative continence.

What are the signs and symptoms of anal fistula?

Anorectal pain, swelling, perianal cellulitis (redness of the skin) and fever are the most common symptoms of an abscess. Occasionally, rectal bleeding or urinary symptoms, such as trouble initiating a urinary stream or painful urination, may be present. Patients with fistulas commonly have a history of a previously drained anal abscess.

What are the symptoms of fistula-in-Ano?

If you have a fistula, you may notice discharge from the opening. This can be pus, blood or even fecal matter. Abscesses sometimes accompany fistulas. These can result in a fever. In some cases, patients may experience fecal incontinence as a symptom of fistula-in-ano. It is not entirely clear what causes all fistulas.

What is the prognosis of Horseshoe abscess and fistula?

Patients with horseshoe abscess or fistulae often require multiple operations for treatment but can expect reasonable rates of long-term success in controlling or curing their disease. Those who undergo posterior midline sphincterotomy seem to benefit with higher rates of improved symptoms. Patients …

What are the complications of a fistula?

In some cases, fistulas might not heal and become chronic. Other potential complications include fecal incontinence, 7  sepsis, perforation, and peritonitis. Sepsis is a life-threatening illness that results from the body’s response to a bacterial infection.