And perianal fistula
Last updated: May 18, Revisions: The majority are associated with anorectal abscess formation, with one third of patients with an anorectal abscess having an associated perianal fistula at the time of presentation. Anal fistulae usually present with either 1 recurrent perianal abcesses 2 intermittent or continuous discharge onto the perineum , including mucus, blood, pus, or faeces. Figure 1 — The Goodsall rule, used clinically to predict the course of a fistula tract. Proctoscopy can be used to visualise the opening of the tract in the anal canal. For complex fistula, MRI imaging is often required to visualise the anatomy of the tract.
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Anal fistula is a chronic abnormal communication between the epithelialised surface of the anal canal and usually the perianal skin. They can form when anal abscesses do not heal properly. Anal fistulae originate from the anal glands , which are located between the internal and external anal sphincter and drain into the anal canal. The tract formed by this process is a fistula. Abscesses can recur if the fistula seals over, allowing the accumulation of pus. It can then extend to the surface again — repeating the process. Anal fistulae per se do not generally harm, but can be very painful, and can be irritating because of the drainage of pus it is also possible for formed stools to be passed through the fistula.
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