What is an Extrasphincteric fistula?
What is an Extrasphincteric fistula?
Extrasphincteric Fistulas: These fistulas often arise in the more proximal rectum rather than the anus and are often sequelae of a procedure. Their external opening is in the perianal area and the tract courses superiorly to enter the anal canal above the dentate line.
How are Extrasphincteric fistula treated?
The standard treatments that can be used are various, mostly surgical in nature, including fistulotomy, excision of the external fistula tract, closure of the internal opening, curettage, endorectal advancement flap, a cutting seton or immediate reconstruction .
What is Transsphincteric perianal fistula?
Transsphincteric fistulae are secondary to ischiorectal abscesses, with a resultant extension of the tract through the external sphincter. Intersphincteric fistulae are due to perianal abscesses. Suprasphincteric fistulae are due to supra levator abscesses.
Which is best surgery for fistula?
Fistulotomy – It is a process in which the surgeon cuts open the whole length of the fistula so as to convert the tunnel into an open groove. This allows the fistula tract to heal up. This procedure can only be done for fistulas with no or very less sphincter involvement.
Can you live with a complex fistula?
Although fistulas are associated with IBD, they can occur several years before the condition is diagnosed. While rarely life-threatening, fistulas can decrease people’s quality of life and often need combined medical and surgical treatment.
Is complex fistula serious?
Complex anal fistula is difficult to treat because of the high risk of recurrence of the disease and the danger of incontinence (losing control over the bowel motions). Apart from regular pus discharge and pain, a complex anal fistula on a long term basis also increases the risk of ano-rectal cancer.
How long does it take to heal from a fistulectomy?
It may take 3-12 weeks to fully recover from a fistulotomy.
Is fistulectomy a minor surgery?
To perform the fistulotomy, the doctor or surgeon will make a small incision in order to sever the abnormal connection between two organs. This allows the organs to move and behave freely and is a very moderate procedure that is not highly invasive for the patient.
Can fistula be cured without surgery?
What is the best treatment for fistula? “There is no fistula treatment without surgery as the fistula cannot heal on its own,” said Dr. Bajaj.
What is the difference between extrasphincteric and superficial fistula?
The extrasphincteric fistula is uncommon and only seen in patients who had multiple operations. In these cases the connection with the original fistula tract to the bowel is lost. A superficial fistula is a fistula that has no relation to the sphincter or the perianal glands and is not part of the Parks classification.
What is the external sphincter made of?
External sphincter: voluntary striated muscle, divided in three layers that function as one unit. These three layers are continuous cranially with the puborectal muscle and levator ani (figure). The puborectal muscle has its origin on both sides of the pubic symphysis, forming a ‘sling’ around the anorectum.
What are the different types of sphincter disorders?
According to Parks, 1976, they are classified as: intersphincteric (60-75%), transsphincteric, low and high level (15-20%), and suprasphincteric (5%) . Different surgical approaches described include transanal, transsphincteric, and transabdominal; however, there is no general consensus regarding optimal treatment.
Where does suprasphincteric fistula start and end?
Suprasphincteric fistula. The tract begins in the space between the internal and external sphincter muscles and turns upward to a point above the puborectal muscle, crosses this muscle, then extends downward between the puborectal and levator ani muscle and opens an inch or two outside the anus. Extrasphincteric fistula.