What is the difference between fistulotomy and fistulectomy?
A fistulectomy involves complete excision of the fistulous tract, thereby eliminating the risk of missing secondary tracts and providing complete tissue for histopathological examination. A fistulotomy lays open the fistulous tract, thus leaving smaller unepithelized wounds, which hastens the wound healing.
What are the types of fistula-in-ano?
Four types were described: intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric. [7] Appropriate classification is essential for adequate treatment and conservation of the external anal sphincter to preserve fecal continence.
How do you classify a fistula?
Type 1 is an intersphincteric fistula that travels along the intersphincteric plane. Type 2 is a transsphincteric fistula that encompasses a portion of the internal and external sphincter. Type 3 is a suprasphincteric fistula that encompasses the entire sphincter apparatus.
How many types of AV fistula are there?
There are 3 basic types of AVF dialysis: Radial Cephalic fistula. Brachial Cephalic. Brachial Basilic Transposition.
What is an Enteroatmospheric fistula?
Enteroatmospheric fistula (EAF), a special subset of enterocutaneous fistula (ECF), is defined as a communication between the gastrointestinal (GI) tract and the atmosphere. It is one of the most devastating complications of “damage control” laparotomy (DCL) and results in significant morbidity and mortality.
What is the most common fistula?
The most common form of fistula – anal fistula—can occur naturally with time. Sometimes a fistula can form between the intestine and the vagina.
What is grade4 fistula?
A 6 o’clock transsphincteric perianal fistula is seen piercing both layers of the sphincter complex and takes a downward course through the ischiorectal and ischioanal fossae before reaching the perineal skin. Small abscess is seen in the tract, making it grade 4 (St James’s University Hospital Classification).
What is a complex fistula?
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].
What causes Enterovesical fistula?
Diverticular disease is by far the most common cause of enterovesical fistula. It accounts for two-thirds or more of this type of fistulae. Diverticular disease is much more common in large bowel than small bowel. Complicated diverticulitis is more likely to cause fistula than non-inflamed diverticula.
What is a Colocutaneous fistula?
An enterocutaneous fistula (ECF) is an abnormal connection that develops between the intestinal tract or stomach and the skin. As a result, contents of the stomach or intestines leak through to the skin.
What is the difference between a fistula and a perforation?
Perforation refers to acute full thickness defect in GI tract. Leaks are defined as disruption of surgical anastomosis resulting in a fluid collection[2]. The term fistula usually means an abnormal communication between two epithelialized surfaces[2].
How painful is a fistulotomy?
Most people have very little pain after several days. But it usually takes several weeks for the area to completely heal. After the area heals, the fistula will be gone. You will probably be able to return to work or your normal routine in 1 to 2 weeks.