they are pathological paths, tubular in shape, which are created between one organ and another or between an internal cavity and the skin. In other words, the fistula (never present in physiological conditions) is an anomalous canal that connects any two structures anatomical close and normally separated. The causes of origin are mainly sought in abscesses, serious inflammations and infections; less often, these particular routes of communication are purposely created by the surgeon for various therapeutic purposes.
RECTUMAGINAL FISTULAS can cause foul-smelling vaginal discharge, recurrent urinary / vaginal tract infections, and pain during intercourse (dyspareunia).
When fistulas arise along the respiratory tract (eg BRONCOESOPHAGEA FISTULA), the patient's clinical picture can dangerously precipitate in a short time, since these channels allow the passage of solid or liquid food particles into the bronchi and lungs. Under such circumstances, the patient can contract extremely dangerous pneumonia.
Some FISTULAS OF THE DIGESTIVE SYSTEM can even cause a very strong and unpleasant halitosis: this is the case of the fistulas that are created between the transverse colon and the upper jejunum: in these cases, the fecal material tends to pass from the colon to the stomach, thus providing breath bad.
Not even DENTAL FISTULAS go unnoticed: persistent toothache is in fact one of the characteristic symptoms of dental fistula, expression of complicated caries, pulpits, gangrene, alveolar abscesses or cysts at the root of the tooth.
Before undergoing the operation, the patient generally undergoes a specific radiological investigation to ascertain the direction, depth, length and precise position of the fistula. This examination, called fistulography, consists in the injection of a special radiopaque contrast liquid directly into the fistulous canal.
Surgery is undoubtedly the first choice solution to drain the lesion: in this way, the pus that has accumulated along the fistula is facilitated, while preventing an abscess from forming (or reforming).
Unfortunately, it is not uncommon for several operations to be required to remove and thoroughly clean a fistula: often, in fact, the fistula recurs after a more or less long period from the operation due to incomplete or incorrect cleaning. the risk of recurrence, many surgeons, at the time of the operation, use the so-called "setone": it is a special thread that is made to slide along the entire path of the fistula in order to better clean the pathological tract.
As for operations on external fistulas - which therefore connect an internal cavity with the skin - the patient's convalescence could be quite annoying. To stop the pain and discomfort caused by the surgery, the patient can take painkilling drugs and carry out compresses with warm water several times a day.
Cleaning must also be scrupulous: to prevent the surgical wound from becoming infected again, it is essential that the patient keeps the wound clean and sanitized.
After the surgery to eliminate the fistula, work and sports activities can be resumed when the patient is able to move freely and easily without feeling any pain.
The implementation of the doctor's advice and the respect for rest minimize the post-surgery risks, while reducing the possibility that the fistula will recur or become chronic.
Tags:
anatomy foods gynecology
To understand: how and why pathological fistulas are formed
Severe inflammation affecting an organ → formation of abscess (purulent infection) that passes through the surrounding tissues → bursting of the abscess → leakage of pus → formation of the tubular duct (fistula) that connects the inflammatory focus with neighboring organs
with the skin (an emblematic example are the ANORECTAL FISTULAS), the patient generally accuses localized burning, discomfort, evident inflammation, swelling, emission of blood or pus from the fistula.RECTUMAGINAL FISTULAS can cause foul-smelling vaginal discharge, recurrent urinary / vaginal tract infections, and pain during intercourse (dyspareunia).
When fistulas arise along the respiratory tract (eg BRONCOESOPHAGEA FISTULA), the patient's clinical picture can dangerously precipitate in a short time, since these channels allow the passage of solid or liquid food particles into the bronchi and lungs. Under such circumstances, the patient can contract extremely dangerous pneumonia.
Some FISTULAS OF THE DIGESTIVE SYSTEM can even cause a very strong and unpleasant halitosis: this is the case of the fistulas that are created between the transverse colon and the upper jejunum: in these cases, the fecal material tends to pass from the colon to the stomach, thus providing breath bad.
Not even DENTAL FISTULAS go unnoticed: persistent toothache is in fact one of the characteristic symptoms of dental fistula, expression of complicated caries, pulpits, gangrene, alveolar abscesses or cysts at the root of the tooth.
Before undergoing the operation, the patient generally undergoes a specific radiological investigation to ascertain the direction, depth, length and precise position of the fistula. This examination, called fistulography, consists in the injection of a special radiopaque contrast liquid directly into the fistulous canal.
Surgery is undoubtedly the first choice solution to drain the lesion: in this way, the pus that has accumulated along the fistula is facilitated, while preventing an abscess from forming (or reforming).
Unfortunately, it is not uncommon for several operations to be required to remove and thoroughly clean a fistula: often, in fact, the fistula recurs after a more or less long period from the operation due to incomplete or incorrect cleaning. the risk of recurrence, many surgeons, at the time of the operation, use the so-called "setone": it is a special thread that is made to slide along the entire path of the fistula in order to better clean the pathological tract.
Did you know that ...
When the fistula is simply eliminated without acting on its cause, in all likelihood, the fistula tends to recur. To give an example, the surgical elimination of a fistula in the context of Crohn's disease can be effective in a first period, but if the triggering disease is not directly addressed with adequate treatment, the fistula tends to recur in 50% of operations.
As for operations on external fistulas - which therefore connect an internal cavity with the skin - the patient's convalescence could be quite annoying. To stop the pain and discomfort caused by the surgery, the patient can take painkilling drugs and carry out compresses with warm water several times a day.
Cleaning must also be scrupulous: to prevent the surgical wound from becoming infected again, it is essential that the patient keeps the wound clean and sanitized.
After the surgery to eliminate the fistula, work and sports activities can be resumed when the patient is able to move freely and easily without feeling any pain.
The implementation of the doctor's advice and the respect for rest minimize the post-surgery risks, while reducing the possibility that the fistula will recur or become chronic.
