A fistula in ano is a tunnel like pipe like track, developed in the perianal region, usually having one or more external openings around the anus leading to an internal opening in the mucosa of the anal canal or the rectum.
Anal fistula, a rare condition, is a chronically inflammed, abnormal tunnel between the anal canal and the outer skin of the anus. It often drains watery pus, which can irritate the outer tissues and cause itching and discomfort.
guidelines to approach an expert for investigating a possibility of anal fistual:
Fistulotomy / Fistulectomy:
The laying-open technique (fistulotomy) is useful for 85-95% of primary fistulae. Complete fistulectomy creates larger wounds that take longer to heal and offers no recurrence advantage over fistulotomy.
A seton ( thread tie ) can be placed alone, combined with fistulotomy, or in a staged fashion. This technique is useful in patients with the following conditions: Complex fistulae (ie, high transsphincteric, suprasphincteric, extrasphincteric) or multiple fistulae Recurrent fistulae after previous fistulotomy With time, healing occurs above the seton as it gradually cuts through the muscles. The seton is tightened on subsequent weekly visits until it falls out. This could take 2-5 visits to cure.