FISTULA

 

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