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Abnormal connection between two epithelialized surfaces, often organs From Wikipedia, the free encyclopedia
In anatomy, a fistula (pl.: fistulas or fistulae /-li, -laɪ/; 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.[2][3][4] An anal fistula connects the anal canal to the perianal skin. An anovaginal or rectovaginal fistula is a hole joining the anus or rectum to the vagina. A colovaginal fistula joins the space in the colon to that in the vagina. A urinary tract fistula is an abnormal opening in the urinary tract or an abnormal connection between the urinary tract and another organ. An abnormal communication (i.e. hole or tube) between the bladder and the uterus is called a vesicouterine fistula, while if it is between the bladder and the vagina it is known as a vesicovaginal fistula, and if between the urethra and the vagina: a urethrovaginal fistula. When occurring between two parts of the intestine, it is known as an enteroenteral fistula, between the small intestine and the skin it's known as an enterocutaneous fistula, and between the colon and the skin as a colocutaneous fistula.[3]
| Fistula | |
|---|---|
| |
| Abdominal CT scan with right colocutaneous fistula and associated subcutaneous pneumatosis | |
| Pronunciation | |
| Specialty | General surgery |
A fistula can result from an infection, inflammation, injury or surgery.[5] Many result from complications during childbirth. Sometimes a fistula is deliberately surgically created as part of a treatment, for example in the case of an arteriovenous fistula for hemodialysis.[6]
The treatment for a fistula varies depending on the type, cause, and severity of the fistula, but often involves surgical intervention combined with antibiotic therapy. In some cases the fistula is temporarily covered using a fibrin glue or plug. A catheter may be required to drain a fistula.[3]
Globally, every year between 50,000 and 100,000 women are affected by one or more fistulas relating to childbirth.[7] Typically they are vaginal fistulas, between either the bowel or bladder and the vaginal canal, but uterine and bowel fistulas also occur.
In botany, the term is most common in its adjectival forms, where it is used in binomial names to refer to a species that is distinguished by one or more hollow or tubular structures. Monarda fistulosa, for example, has tubular flowers.[8]
The term was first used in the 14th century.[2]
A fistula is an abnormal connection between vessels or organs that do not usually connect. It can be due to a disease or trauma, or purposely surgically created.[3][5]
Various types of fistulas include:
Although most fistulas are in forms of a tube, some can also have multiple branches.[9]
Types of fistula can be described by their location. Anal fistulas connect between the epithelialized surface of the anal canal and the perianal skin. Anovaginal or rectovaginal fistulas occur when a hole develops between the anus or rectum and the vagina. Colovaginal fistulas occur between the colon and the vagina. Urinary tract fistulas are abnormal openings within the urinary tract or an abnormal connection between the urinary tract and another organ such as between the bladder and the uterus in a vesicouterine fistula, between the bladder and the vagina in a vesicovaginal fistula, and between the urethra and the vagina in urethrovaginal fistula. When occurring between two parts of the intestine, it is known as an enteroenteral fistula, between the small intestine and the skin as an enterocutaneous fistula, and between the small intestine and the colon as a colocutaneous fistula.[3]
The following list is sorted by the International Statistical Classification of Diseases and Related Health Problems.
Treatment for fistula varies depending on the cause and extent of the fistula, but often involves surgical intervention combined with antibiotic therapy. In some cases the fistula is temporarily covered, using a fibrin glue or plug. Catheters may be required to drain a fistula.[3]
Surgery is often required to assure adequate drainage of the fistula (so that pus may escape without forming an abscess). Various surgical procedures are used, most commonly fistulotomy, placement of a seton (a cord that is passed through the path of the fistula to keep it open for draining), or an endorectal flap procedure (where healthy tissue is pulled over the internal side of the fistula to keep feces or other material from reinfecting the channel).[19]
Management involves treating any underlying causative condition. For example, surgical treatment of fistulae in Crohn's disease can be effective, but if the Crohn's disease itself is not treated, the rate of recurrence of the fistula is very high (well above 50%).
In people with kidney failure, requiring dialysis, a cimino fistula is often deliberately created in the arm by means of a short day surgery in order to permit easier withdrawal of blood for hemodialysis.[citation needed]
As a radical treatment for portal hypertension, surgical creation of a portacaval fistula produces an anastomosis between the hepatic portal vein and the inferior vena cava across the omental foramen (of Winslow). This spares the portal venous system from high pressure which can cause esophageal varices, caput medusae, and hemorrhoids.[citation needed]
Globally, every year between 50,000 and 100,000 women are affected by fistula relating to childbirth.[7]
In botany, the term is most common in its adjectival forms, where it is used in binomial names to refer to species that are distinguished by hollow or tubular structures. Monarda fistulosa, for example, has tubular flowers;[8] Eutrochium fistulosum has a tubular stem; Allium fistulosum has hollow or tubular leaves, and Acacia seyal subsp. fistula is the subspecies with hollow spines.[citation needed]
The term was first used in the 14th century.[2]
A fistula plays an central role in William Shakespeares play All's Well That Ends Well
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