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Anal fistula

Anal fistula is an abnormal track (lined by granulation tissue) connected between the anal canal or rectum and the perianal skin.
Usually results from anorectal abscess due to blocked infected anal glands lying between the two layers of anal sphincters

  • Normally anal glands drain into anal canal.
  • If outlet of these glands is blocked, this results into abscess and eventually point out to skin surface.
  • Tract formed by this process is a fistula.
  • If the track does not communicate with anal canal then it is called a sinus.
  • Abscess can reoccur if fistula seals over, allowing the pus to accumulate and points to surface again and the process repeats.


  • Anal fistula usually do not harm but can be vary painful with tender swelling
  • Irritating due to pus discharge
  • Discharge- Bloody or purulent
  • Recurrent abscess formation
  • Systemic spread of infection

Types of FISTULA


Divided into two groups depending upon their internal opening below or above the ano rectal ring

Low level – Open below the anorectal ring and have 5 varieties
High level – Open at or above anorectal ring and have 3 varieties

Fig. I23I. Fig. I232.
Fig. I23I.-Types of anal fistulae
(standard classification). I. Subcutaneous,
2. submucous, 3. low anal, 4. high anal, 5. pelvi-rectal.
Fig. I232.-Types of Anal Fistulae, I. Intersphincteric, 2. transphincteric (which may be high or low), 3. supralevator.


Hall mark of treatment of fistula is to :
  • Close the internal opening
  • Take care of tract
  • Not to damage the sphincters
  • stop recurrence

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Presentation of Prospective Analysis of 48 Consecutive Cases of VAAFT

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