Fistulas of the rectum

Fistulas of the rectum are pathologically formed passages in the rectal wall, usually in the region of blinkers crypts, and terminate in the near-intestinal tissue (incomplete internal) or more often open on the skin around the anus (full outer).

Pathogenesis. After spontaneous or surgical opening of the paraproctitis, the communication with the lumen of the rectum is maintained due to the constant infection and formation of scar-altered tissues around the opening in the rectal mucosa (in the crypt zone).

Symptoms, course. With complete external fistulas on the skin around the anus or on the buttocks, one or more pointing holes are found with tissue tightening around and permanent or periodic separation of mucus or pus and maceration of the surrounding skin. Finger examination of the rectum allows you to determine the funnel-shaped opening in the area of ​​one of the crypts (the inner hole of the fistula). With incomplete internal fistulas, patients feel a foreign body in the anus, pain, periodic discharge of mucus and pus from the rectum, irritating the skin around the anus. In both cases, with a violation of outflow from the fistula, there is a relapse of the acute inflammatory process with symptoms characteristic of it (pain, fever, chills, etc.). The fistula is not prone to healing and usually does not respond to conservative treatment, especially this refers to complex fistulas passing through the muscle fibers of the anal beetle or enveloping it (trans- and extra-fricative fistula).

Treatment is surgical. The prognosis for life and ability to work in most patients is favorable, especially after qualified surgical treatment. Long-existing fistulas can lead to complications of a general nature that are associated with a chronic purulent process. Sometimes malignant fistula is observed.