Causes, forms and treatment of fistula
A canal connecting an organ to the body surface or two cavities to each other is called a fistula. The main cause of its occurrence is a pathological process in the body. A fistula can also develop as a complication after surgery. Treatment of fistula is only surgical. The exception is granular fistulas, which can heal on their own.
Classification (depending on the location):
- rectal
- rectovaginal
- duodenal
- bronchial;
- gastric.
The forms of fistula are complete and incomplete. Taking into account the origin, fistulas are divided into: congenital, acquired and created artificially (surgery).
Causes of occurrence:
- Crohn's disease, tuberculosis
- actinomycosis;
- chronic ENT pathology;
- neoplasms
- dental diseases;
- paraproctitis;
- surgical intervention (fistula after surgery).
Clinical manifestations
Symptoms depend on the cause and location of the fistula. Common manifestations are subfebrile fever, weakness, loss of appetite, headache, sleep disturbance, pain, discharge from the fistula.
Fistula of the rectum. The main cause is paraproctitis. Depending on the location of the fistula in relation to the anus, there are intrasphincteric, transsphincteric and extrasphincteric fistula. The first two types are the most common and can be treated well. Extrasphincteric fistula of the rectum is the most difficult type, which affects most of the sphincter. Treatment is long in several stages.
Symptoms:
- redness of the skin around the anus;
- discomfort and pain in the anus area
- stool retention;
- pathological discharge from the rectum (pus, mucus);
- fever;
- deformation of the anus;
- sphincter dysfunction.
In addition, the patient may complain of generalized weakness, fatigue, irritability, headache, sleep disturbance. After fistula removal, the condition normalizes within 7-10 days. The recovery period depends on the form of the pathology, the patient's age, and the presence of concomitant pathology.
Diagnosis, fistula removal
The doctor will make a diagnosis after examining the patient, collecting complaints and obtaining the results of additional examinations, which include: general blood and urine tests, sounding, MRI and CT scans, examination of purulent fluid and blood culture. The most effective diagnostic method is considered to be radiography with the introduction of a contrast agent into the cavity, which will help determine the length and size of the fistula. Ultrasound examination in this case is not very informative. After receiving the results, the doctor will prescribe treatment (most often it is a fistula surgery) and tell you about the possible consequences.
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Treatment of fistula
The main method of treatment is surgical intervention. Drug therapy is used as an adjunctive treatment to relieve symptoms and speed up recovery after surgical fistula removal.
Methods of surgical intervention:
- laser cauterization
- excision with plastic surgery;
- excision with wound suturing;
- ligature method;
- “filling” of the fistula course.
Contraindications to the surgery: infectious diseases, severe general condition of the patient, blood clotting disorders, decompensation of chronic pathologies.
After the surgery, the patient stays in the hospital for a week. The patient is prescribed plenty of fluids, a sparing diet, and drug therapy (antibiotics, painkillers, laxatives). Sitz baths with an antiseptic solution are recommended.
The prognosis of the disease with early diagnosis and proper treatment is favorable.
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