How is fistula in ano classified?

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.

Will an MRI show a fistula?

Magnetic resonance imaging (MRI) is the best imaging modality for preoperative assessment of patients with anal fistula. MRI helps to accurately demonstrate disease extension and predict prognosis.

What is the commonest type of fistula in ano?

In order of most common to least common, the various types include:

• Intersphincteric fistula. The tract begins in the space between the internal and external sphincter muscles and opens very close to the anal opening.
• Transphincteric fistula.
• Suprasphincteric fistula.
• Extrasphincteric fistula.

What are the stages of fistula?

Cases were staged as stage I–low (less than 4 cm from anal verge and nonirradiated), stage II–high (more than 4 cm from anal verge and nonirradiated), stage III–small (less than 2 cm irradiated fistula), stage IV–large (more than 2 cm irradiated fistula) and stage V–large (ischial decubitus fistula).

What is the treatment of fistula in ano?

Fistulotomy. The most common type of surgery for anal fistulas is a fistulotomy. This involves cutting along the whole length of the fistula to open it up so it heals as a flat scar.

Which antibiotic is best for fistula?

Antibiotics may be necessary for the treatment of anal fistulas, especially if the patient presents with systemic symptoms. Postoperative prophylactic antibiotic therapy for 7-10 days (eg, ciprofloxacin, metronidazole) appears to be a key part of preventing anal fistulas after incision and drainage of perianal abscess.

How long does it take to heal from fistula surgery?

You can put a gauze pad over the opening of the fistula to absorb the drainage, if needed. Most people can go back to work and their normal routine 1 to 2 weeks after surgery. It will probably take several weeks to several months for your fistula to completely heal.

What is the fastest way to recover from a fistula surgery?

Other instructions

1. Place a maxi pad or gauze in your underwear to absorb drainage from your fistula while it heals.
2. Sit in a few inches of warm water (sitz bath) for 15 to 20 minutes.
3. Apply ice several times a day for 10 to 20 minutes at a time.
4. Support your feet with a small step stool when you sit on the toilet.

What does it mean to have a fistula in Ano?

Perianal fistula (or fistula-in-ano) is the presence of a fistulous tract across/between/adjacent to the anal sphincters and is usually an inflammatory condition 4.

How is magnetic resonance imaging used to evaluate fistulas?

Until recently, imaging techniques played a limited role in evaluation of perianal fistulas. However, magnetic resonance (MR) imaging now provides more precise information on the anatomy of the anal canal, the anal sphincter complex, and the relationships of the fistula to the pelvic floor structures and the plane of the levator ani muscle.

What is the radiological classification for a perianal fistula?

Radiological classification. Radiologists have developed another grading system for perianal fistulae, which is based on landmarks on the axial plane and incorporates abscesses and secondary extensions to the grading system, and is called the St James’s University Hospital classification 1:

Where does the fistulous track of translevator disease begin?

In translevator disease, the fistulous track extends directly from its origin in the pelvis to the perineal skin through the ischiorectal and ischioanal fossae, with no involvement of the anal canal. These fistulas indicate the existence of primary pelvic disease with extension through the levator plate (Figs 16, 17).

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