Anorectal Fistula

Reviewed 06/2017
 


BASICS

DESCRIPTION

  • An anorectal fistula is an open communication between an anal abscess and the perirectal skin.

  • Anorectal fistulas typically form from an abscess of the anal crypt glands.

  • The classific...

DIAGNOSIS

HISTORY

  • Perianal pain, pruritis, purulent (often malodorous) perianal drainage, and perirectal skin lesions

  • Intermittent rectal pain is worse with defecation or sitting.

  • Fever most common with ...

TREATMENT

GENERAL MEASURES

  • Surgical treatment is definitive 1[A].

  • Optimal surgical treatment based on correct fistula classification

  • Goals of treatment include resolving the inflammatory process, maintai...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Resumption of activity as tolerated after surgery 

Patient Monitoring

Anoscopy at 3 to 6 months following procedure; frequent follow-up to ensure complete healing a...

REFERENCES

Whiteford  MH, Kilkenny J  , III, Hyman  N, et al. Practice parameters for the treatment of perianal abscess and fistula-in-ano (revised). Dis Colon Rectum.  2005;48(7):1337–1342. [Vi...

ADDITIONAL READING

  • A ba-bai-ke-re MM, Wen H, Huang HG, et al. Randomized controlled trial of minimally invasive surgery using acellular dermal matrix for complex anorectal fistula. World J Gastroenter...

SEE ALSO

Anorectal Abscess; Crohn Disease 

CODES

ICD10

  • K60.5 Anorectal fistula

  • K60.3 Anal fistula

  • K60.4 Rectal fistula

ICD9

565.1 Anal fistula 

SNOMED

  • 72779005 Anorectal fistula

  • 197155003 intersphincteric fistula (disorder)

  • 261827001 high anal fistula ...

CLINICAL PEARLS

  • Suspect anorectal fistula in patients with perianal pain, pruritis, purulent drainage, and perirectal skin lesions.

  • Surgery is the traditional mainstay of treatment in patients who do n...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

 
×