Colon & Rectal Surgery

Rectal Cancer

Delta Medix Patient General Information

Excision of Anal Fistula (Fistulotomy)

An anal fistula is an abnormal tract or small tunnel that begins in the anal canal and exits in the skin around the anus. An anal fistula usually begins as an anorectal abscess inside the anus where there are a number of small glands. Quite often an abscess occurs when one of these glands becomes blocked. The abscess erodes into the tissue towards the outside of the body until it creates a small hole in the skin and drains.

Many patients will have had a prior history of anorectal abscesses and once the fistula tract develops, it is usually not associated with pain. The major complaint is that of a constant purulent drainage.

Conservative management such as medications, warm baths, etc., is not really an option with a fistula. The tract is lined by chronically inflamed tissue that must be surgically treated. The surgical treatment for an anal fistula is referred to as a fistulotomy.

A fistulotomy or excision of an anal fistula is a procedure in which the skin and muscle over the tunnel are cut open, converting it into an open groove. During the surgical procedure, the first step is to identify the fistula tract. This is usually done by placing a probe in the tract from one opening to the next. The fistula is then opened along the entire length of the tract. Because the inner lining of the fistula tract is scar tissue, the tract is left open and will heal on its own from the inside out.