Is It an Anal Fistula? Urgency for Surgical Treatment

Suspected fistula?

Hello doctor, I would like to ask if this is an anal fistula? If so, I would like to know about the urgency of surgery.
Thank you.

Shen, 20~29 year old female. Ask Date: 2021/03/27

Dr. Ke Fangxu reply Surgery

Based solely on photos, it is not possible to definitively diagnose an anal fistula.
A necessary condition for diagnosis is the physical examination to feel for a hard fistula tract.
It is advisable to consult a colorectal specialist for a thorough examination.
While the urgency is not critical, it is best not to delay too long to avoid the risk of infection.

Reply Date: 2021/03/27

More Info

An anal fistula is an abnormal connection between the anal canal and the skin surrounding the anus. It often arises as a complication of an anal abscess, which is a collection of pus that forms due to infection. The symptoms of an anal fistula can include pain, swelling, and discharge of pus or blood from the opening near the anus. If you suspect that you have an anal fistula, it is crucial to seek medical advice promptly.

The urgency for surgical treatment of an anal fistula depends on several factors, including the severity of symptoms, the presence of infection, and the overall health of the patient. In many cases, surgery is the definitive treatment for an anal fistula, as it can help to eliminate the abnormal connection and prevent recurrent infections.
Surgical options typically include:
1. Fistulotomy: This is the most common procedure, where the fistula tract is opened and laid flat to heal from the inside out. This method is effective for simple fistulas.

2. Seton placement: In cases where the fistula is complex or involves a significant amount of sphincter muscle, a seton (a piece of surgical thread) may be placed to help drain the fistula and promote healing over time.

3. Fistula plug: This is a newer technique where a bioprosthetic plug is inserted into the fistula to promote healing.

4. LIFT procedure (Ligation of the Intersphincteric Fistula Tract): This technique involves identifying and ligating the fistula tract to promote healing.

The decision on which surgical approach to take will depend on the specific characteristics of the fistula, including its location and complexity, as well as the patient's overall health and preferences.

In terms of urgency, if you are experiencing significant pain, fever, or any signs of infection (such as increased redness, swelling, or discharge), it is advisable to seek surgical evaluation as soon as possible. Delaying treatment can lead to complications, including worsening infection or the development of more complex fistulas that may require more extensive surgical intervention.

In summary, if you suspect that you have an anal fistula, it is essential to consult with a healthcare provider who can perform a thorough examination and recommend the appropriate treatment. Early intervention can lead to better outcomes and reduce the risk of complications. If surgery is indicated, addressing the issue promptly can help alleviate symptoms and improve your quality of life.

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