Fistula-in-ano (Fistula, Anal Fistula, Anorectal Fistula)

A fistula is an abnormal communication between two surfaces of the body. In the case of an anorectal fistula, it is a small tract (tunnel) that goes from the anal canal through the anal muscle and out through the surface of the skin somewhere around the anus. One can usually feel a fistula track like a firm cord under the skin. The most common cause of a fistula is a previous abscess that has either drained spontaneously through the skin or was opened as an urgent procedure to drain an abscess. These abscesses are from infected fissures or anal glands. If identified early, some fistulas may be cured by simple measures including antibiotics. But most will require surgery. Surgery for fistulas may be simple if the fistula is short and superficial, or very difficult if the fistula is complex and travels deeply through the sphincter muscle.

Michael E Pezim, MD FRCSC FACS
Pezim Clinic, Vancouver, British Columbia, Canada