An anal fistula is an abnormal tunnel between the anal canal and the skin that should not normally exist. The most common cause is a previously experienced anal abscess.
Classification
According to Parks classification, there are four types: intersphincteric, transsphincteric, suprasphincteric and extrasphincteric. The classification directly affects the surgical approach.
Symptoms
Continuous or intermittent discharge (purulent or bloody) near the anus, pain, itching and recurrent abscess formation.
Diagnosis
Anoscopy, proctoscopy, MRI fistulography and endoanal ultrasound are used to identify the fistula tract.
Treatment
Fistulotomy (for simple fistulas), seton placement, fibrin glue or anal fistula plug, LIFT (ligation of intersphincteric fistula tract) and flap procedures are used in complex cases.