Fistula
It is an abnormal communication between the lumen of oneviscus to another or the body surface or between the vessels.
Causes
A) Congenital : from the time of birth ;
1) Branchial fistula
2) Tracheo-oesophageal fistula
3) Congenital AV fistula
4) Umbilical fistula
B) Acquired : obtained after birth ;
1) Traumatic : Intestinal fistulas , vesicovaginal fistula.
2) Inflammatory-intestinal tuberculosis
3) Malignancy
Clinical Features
- Discharge from the opening of sinus
- Raised indurated edge, indurated base,non mobile
- Bone thickening in osteomyelitis
- Enlargement of regional lymph nodes will be evident
Investigation
✓ Fistulogram/sinusogram
✓ Chest x-ray to see for tuberculosis
✓ ESR
✓ Biopsy from the edge for tuberculosis and malignancy
TREATMENT
a) treat the cause
b) excision of sinus or fistulas
c) antibiotics,anti tubercular drugs
d) adequate drainage
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