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Anal fistula is a chronic abnormal communication between the anal canal and the perianal skin. [1] An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. [2]
Goodsall's rule relates the external opening (in the perianal skin) of an anal fistula to its internal opening (in the anal canal). It states that if the perianal skin opening is posterior to the transverse anal line, the fistulous tract will open into the anal canal in the midline posteriorly, sometimes taking a curvilinear course.
In anatomy, a fistula (pl.: fistulas or fistulae /-l i,-l aɪ /; from Latin fistula, "tube, pipe") is an abnormal connection (i.e. tube) joining two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow organs to each other, often resulting in an abnormal flow of fluid from one space to the other.
Doctors uses a variety of tools and techniques to evaluate the type of anorectal disorder, including digital and anoscopic investigations, palpations, and palpitations.The initial examination can be painful because a gastroenterologist will need to spread the buttocks and probe the painful area, which may require a local anesthetic.
There are several forms of imperforate anus and anorectal malformations. The new classification is in relation of the type of associated fistula. [7] The Wingspread classification was in low and high anomalies: [citation needed] A low lesion, in which the colon remains close to the skin.
Anorectal anomalies are congenital malformations of the anus and rectum. [1] One anal anomaly, imperforate anus has an estimated incidence of 1 in 5000 births. [2] [3] It affects boys and girls with similar frequency.
They usually occur to the sides of the sphincters, and between the internal and external sphincters, either on the surface, or deeper. They may get bigger, enlarging in the direction of the rectum, and resulting in an abnormal connection called an anorectal fistula. They are usually managed with surgical drainage [9] and antibiotics. [10] [11]
Anorectal abscess (also known as an anal/rectal abscess or perianal/perirectal abscess) is an abscess adjacent to the anus. [1] Most cases of perianal abscesses are sporadic, though there are certain situations which elevate the risk for developing the disease, such as diabetes mellitus, Crohn's disease, chronic corticosteroid treatment and others.