What Are Fistulas?

A fistula is a pathological pus drainage tube connected between the body and a cavity organ or between two cavity organs caused by an abscess. It usually has two or more openings. The former is called an external fistula. Inner mouth, such as intestinal fistula, anal fistula, etc .; the latter is called internal fistula, only the inner mouth, such as rectal bladder fistula, gastrocolonic fistula and so on. Fistula spills vary depending on the organs connected to them, and can be digestive fluid, feces, urine, or other secretions.

Basic Information

Visiting department: General Surgery
Common causes: Can be caused by abnormal embryo development, infection, surgery, etc.

Common symptoms: Persistent or bad or bad, local swelling, etc.
Contagious: no

Causes of fistula

1. Congenital is caused by abnormal embryonic development, such as thyroid hyoid fistula, rectal vaginal fistula, bladder vaginal fistula, ear fistula, nasal fistula and so on.
2. The infection is caused by the abscess ulceration after infection, such as anal fistula, intestinal fistula and so on.
3 Surgery is performed to remove an organ obstruction, and a fistula formed by artificial fistula; or after various types of surgery, fistulas occur due to infection, poor anastomotic healing, suture fall-off, and erroneous operation. Such as gastric fistula, intestinal fistula, biliary fistula, pancreatic fistula, renal fistula, bladder fistula, anal fistula and so on.
4 When mechanical compression is difficult, for example, the fetal head compresses the vagina for a long time, and a bladder vaginal fistula can be formed.
5. Tumor malignant tumor ulceration can lead to fistula, such as salivary gland fistula, rectal fistula and so on.

Clinical manifestations of fistula

Fistulas are characterized by longevity or good times. Local swelling and pain occur, often accompanied by secretions, such as intestinal fluid, bile, urine, etc., and the channels have various shapes. May be accompanied by fever and other systemic symptoms.

Fistula examination

1. Laboratory tests include blood routine, blood biochemistry, bacterial culture and drug sensitivity tests, and biopsy pathology.
2. Imaging examination includes B-mode ultrasound and contrast examination.

Fistula diagnosis

1. He has a history of trauma, surgery or tumor.
2. Clinical manifestations (1) According to the nature of the secretion, it is helpful to determine which organ the fistula is in communication with.
(2) Determine the type based on the anatomical position of the fistula.
3 Examination of the total number of white blood cells, an increase in the proportion of neutrophils, and a positive bacterial culture are helpful for diagnosis; the results of the imaging examination can determine the path, range, branches, communicating organs and internal mouth of the fistula.

Differential diagnosis of fistula

Differentiation from the sinus tract: The sinus tract is a pathological blind tube that leads from the deep tissue to the body surface and has only one opening.

Fistula treatment

1. General treatment: anti-infection, strengthen nutrition, correct water and electrolyte imbalance, etc .; perform temporary artificial ostomy, most of them can heal after removing the catheter.
2. Surgical treatment (1) Fecal scraping for chronic superficial external fistula is feasible.
(2) Congenital fistula, specific infection fistula, and epithelial cells on the inner wall of the fistula cannot heal by themselves, and should be treated thoroughly. When performing a fistula resection, the diseased tissue and the scar surrounding the fistula must be completely removed.
(3) Fistulas in special parts, such as anal fistulas, need to protect the anal sphincter during operation to avoid postoperative fecal incontinence. The hanging method can be used to change the bath after surgery.
3 Negative pressure suction treatment: When intestinal fistula, biliary fistula, etc. are used to correct the water and electrolyte balance and nutritional supplementation, the fistula can be fully negative pressure suctioned, and often heal itself. If the water and electrolytes are lost for a long time, surgery should be performed as soon as possible.