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Anorectal Fistula

Nihal K. Patel, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • An open communication between the anal canal and perirectal skin. Anorectal fistulas typically form from an abscess of the anal crypt glands.

  • In patients with perianal Crohn disease, ...

DIAGNOSIS

HISTORY

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

  • Intermittent rectal pain worse with defecation/sitting

  • Fever most common with abscess...

TREATMENT

GENERAL MEASURES

  • Surgical treatment is definitive (1)[A].

  • Optimal surgical treatment is based on fistula classification.

  • Goals of treatment are to eliminate the inflammatory process, maintain ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Resumption of activity as tolerated after surgery 

Patient Monitoring

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

REFERENCES

1
Whiteford  MH, Kilkenny  JIII, Hyman  N, et al; for Standards Practice Task Force, American Society of Colon and Rectal Surgeons. Practice parameters for the treatm...

SEE ALSO

Anorectal Abscess; Crohn Disease 

CODES

ICD10

  • K60.5 Anorectal fistula

  • K60.3 Anal fistula

  • K60.4 Rectal fistula

SNOMED

  • 72779005 Anorectal fistula

  • 197155003 intersphincteric fistula (disorder)

  • 261827001 high anal fistula (disorder)

  • 235793000 Sup...

CLINICAL PEARLS

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

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

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