It is a medical condition defined as an abnormal connection between a two-chambered organ or an organ and the body surface. Such connections are not normally found in the body. Fistula usually occurs after infection, injury or surgery. Fistulas can occur in different parts of the body and require medical treatment.
Types of Fistula
Anorectal Fistula: One of the most common types of fistula, anorectal fistula occurs between the anus or rectum and the skin surface. It usually develops after an anal abscess bursts and can recur if left untreated. It can cause pain and discharge during bowel movements.
Enterocutaneous Fistula: Occurs between the intestine and the skin. It develops after abdominal surgery or in cases of intestinal inflammation (such as Crohn's disease). Contents leaking from the intestine are excreted through the skin, which can increase the risk of infection.
Vesicovaginal Fistula: There is an abnormal connection between the bladder and the vagina. It can cause urine to flow out of the vagina involuntarily. It usually develops after a difficult birth, gynecological surgery, or pelvic cancer treatment.
Tracheoesophageal Fistula: It develops between the esophagus and the trachea. It may be congenital or may occur later due to certain diseases. It causes nutrients to leak into the trachea and recurrent lung infections.
Arteriovenous Fistula: An abnormal connection between an artery and a vein. It can affect blood flow and is usually corrected with surgery. In some cases, it may be created intentionally for dialysis.
Fistula Symptoms
Fistula symptoms vary depending on the type of fistula and the area where it occurs. However, discharge, pain, and inflammation in the fistula area are common symptoms. More specific symptoms occur depending on where the fistula is located.
1. Anorectal Fistula: This type of fistula, seen around the anus and rectum, manifests itself with pain and discomfort. Pain that worsens during or after bowel movements is accompanied by purulent or bloody discharge. A constant feeling of irritation and itching is also common.
2. Enterocutaneous Fistula: When there is a connection between the intestine and the skin, there may be a continuous discharge from the skin surface to the outside. This discharge usually contains undigested food or intestinal fluid and increases the risk of infection. There is also tenderness and pain in the abdominal area.
3. Vesicovaginal Fistula: A fistula between the bladder and the vagina manifests itself with involuntary urinary incontinence. Urine leaks out of the vagina, causing constant discomfort and skin irritation. This condition is often accompanied by urinary tract infections.
4. Tracheoesophageal Fistula: Between the esophagus and the trachea, liquid or food leaks into the trachea. This leads to cough, shortness of breath and recurrent lung infections.
5. Arteriovenous Fistula: In this type, there is an abnormal blood flow between the veins, swelling and pain may be felt. Circulatory problems may be observed in the area where the fistula is located.
Depending on the severity of the symptoms, medical attention may be required, so it is important to seek medical attention quickly when in doubt.
Fistula Causes
Fistulas are abnormal connections that do not naturally occur in the body. , can occur as a result of various medical conditions, injuries and surgical interventions. The main causes of fistula formation are:
1. Infections: One of the most common causes of fistula is inflammatory diseases and abscess formations in particular. For example, it occurs when abscesses develop as a result of infection in the anorectal anal region and burst. It also develops between the intestines or between the skin and the intestines in cases where the intestines are inflamed, such as Crohn's disease.
2. Surgical Interventions: There is a risk of formation after abdominal, pelvic or gastrointestinal surgeries. Tissue damage or problems with wound healing during surgery cause the disease to develop. Especially after intestinal surgery, fistulas may form from the intestine to the skin surface.
Accidents, falls, or other physical trauma can damage internal organs, creating abnormal connections (fistulas) between organs. This is especially true in the intestines or urinary tract.
Radiotherapy can cause tissue damage when applied to the pelvic area, which can lead to fistulas between the vagina, bladder or bowel.
Difficult birth causes diseases such as vesicovaginal fistula between the urinary tract and the reproductive organs. Especially during long-lasting births, damage may occur between the vagina and the bladder.
Chronic inflammatory bowel diseases can cause weakening of the intestinal wall, leading to fistula development.
Fistula Treatment
1. Surgical Intervention: Surgical intervention is the most common treatment method for many types of fistula. The fistula tract (channel) is usually closed or removed. Surgical operation, especially in anorectal fistulas, allows the fistula to be cleaned. In some cases, the fistula channel is completely opened and cleaned with a procedure called fistulotomy and left to heal naturally.
2. Seton Application: Another method used for anorectal fistulas is the seton application. Seton allows the fistula channel to gradually close by means of a suture or tube placed inside the fistula tract. This method is especially preferred in cases where the fistula is not suitable for full surgical intervention.
3. Medication: If the cause is inflamed bowel, medications recommended by the doctor can help it heal. In case of infection, antibiotic treatment may also be necessary.
4. Wound Care and Drainage: If there is an infection or abscess, drainage is performed before surgery. This allows the pus to drain out, preventing the spread of infection and facilitating surgery.
5. Fibrin Glue: In some cases, fistulas can be closed with non-surgical methods. Fibrin glue is injected to close the fistula. Healing can be achieved without the need for surgical intervention.
6. Colostomy: In very serious and complicated cases, it is applied to rest the intestines and heal the fistula. During this procedure, the stool is directed out of the body by opening a temporary exit from the intestine.
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