- Related Topics:
- human disease
- obstetric fistula
- oro-antral fistula
fistula
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What is a fistula in medicine?
A fistula is an abnormal connection between organs or other structures in the body. Fistulas can occur in many areas, such as between the uterus and the peritoneal cavity, an artery and a vein, or the intestines and the vagina. They can be complete, with both internal and external openings, or incomplete, with only one opening.
Fistulas can result from wounds, congenital disorders, vascular disease, or other conditions. Symptoms vary depending on the location of the fistula but may include diarrhea, incontinence, abdominal pain, or cough. While some fistulas close on their own, many require surgical repair, such as fistulotomy for anal fistulas or reconstructive surgery for vaginal fistulas. Fibrin glue is sometimes used to plug fistulas in the anus, gastrointestinal tract, or lungs.
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How does a fistula form in the body?
A fistula is an abnormal passageway between organs that can occur in various parts of the body. Fistulas can be complete, with internal and external openings, or incomplete, with only an external opening.
Fistulas may result from wounds, congenital disorders, vascular disease, abscesses, infection, or surgery. For example, tuberculosis may cause bronchopleural or anal fistulas, and anal fistulas can arise from complications of bowel diseases like Crohn disease or parasitic diseases. Obstetric fistulas often stem from childbirth complications that cause a prolonged decrease in blood supply to the vagina and bladder or rectum.
Symptoms vary depending on the fistula's location and can include diarrhea, incontinence, abdominal pain, cough, and purulent sputum. While some fistulas may close independently, many, especially those involving the anus, bladder, or vagina, typically need surgical repair.
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Where in the body can fistulas commonly occur?
Fistulas can occur in various parts of the body, forming abnormal passageways between organs. Common locations include:
- Between the uterus and the peritoneal cavity (metroperitoneal fistula)
- Between an artery and a vein (arteriovenous fistula)
- Between the bronchi and the pleural space of the lung (bronchopleural fistula)
- Between the intestines and the vagina (enterovaginal fistula)
- Between the urinary tract and the vagina (vesicovaginal fistula)
- Between the rectum and the vagina (rectovaginal fistula)
- Between the stomach and the skin surface (gastric fistula)
Fistulas involving the gastrointestinal tract, bladder, or vagina can cause diarrhea, incontinence, dehydration, or abdominal pain. Bronchopleural fistulas may result in cough and purulent sputum production. Arteriovenous fistulas are associated with aching pain, puffy legs, distended veins, and a continuous heart murmur.
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What symptoms might a person with a fistula experience?
A fistula is an abnormal passageway between organs that can occur in various parts of the body. Symptoms vary depending on the location of the fistula.
Gastrointestinal, bladder, or vaginal fistulas may result in diarrhea, incontinence, dehydration, or abdominal pain. Bronchopleural fistulas can cause a cough with yellowish or greenish sputum. Arteriovenous fistulas are associated with aching pain in the area of the defect, puffy legs with distended veins, and a continuous heart murmur.
Untreated fistulas can lead to increased risk of infection, skin irritation, kidney disease, ulcer, malnutrition, dehydration, incontinence, and neurological disease.
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What can cause a fistula to develop?
Fistulas, abnormal passageways between organs, can arise from various factors such as wounds, congenital disorders, or vascular disease. Abscesses, infections, or surgery can also lead to fistula development. For example, tuberculosis may cause anal or bronchopleural fistulas.
Additionally, fistulas can occur as complications from bowel diseases like Crohn disease or parasitic diseases. In women, obstetric fistulas can result from complications during labor or from sexual violence. Symptoms vary depending on the location and can include pain, incontinence, dehydration, and other signs of infection.
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How are fistulas diagnosed and treated by doctors?
A fistula is an abnormal passageway between organs that can occur in various parts of the body. Symptoms vary depending on the location and can include diarrhea, incontinence, abdominal pain, cough, and aching pain.
Diagnosis may involve physical examination and imaging techniques to locate the fistula. While some fistulas may close on their own, many require medical intervention, often surgical repair. Procedures such as fistulotomy may be used for anal fistulas, while intravaginal surgery can repair vaginal fistulas. In some cases, fibrin glue may be used to plug fistulas. Untreated fistulas carry risks of complications like infection and kidney disease.
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fistula, abnormal duct or passageway between organs. Fistulas can form between various parts of the body, including between the uterus and the peritoneal cavity (metroperitoneal, or uteroperitoneal, fistula), between an artery and a vein (arteriovenous fistula), between the bronchi and the pleural space of the lung (bronchopleural fistula), between the intestines and the vagina (enterovaginal fistula), between the urinary tract and the vagina (vesicovaginal fistula), and between the stomach and the skin surface (gastric fistula). Vesicovaginal fistula, as well as rectovaginal fistula (a passageway between the rectum and the vagina), are classified as types of obstetric fistula.
Fistulas may be described as complete, in which there are internal and external openings, or incomplete, in which there is an external opening and no internal opening. A blind fistula is one in which two structures are connected, but with an opening on only one end; thus a blind fistula may also be an incomplete fistula. Horseshoe fistulas run between the anus and the skin surface, connecting the two via a passageway that curves around the rectum.
Fistulas may be caused by wounds, congenital disorders, vascular disease, abscesses, infection, or surgery. Tuberculosis may cause bronchopleural fistulas or anal fistulas. In addition, anal fistulas sometimes occur as complications of serious bowel diseases, as in Crohn disease, or as a result of certain parasitic diseases. Some patients with Crohn disease develop fistulas connecting the bowel to the bladder or the vagina; these channels often lead to abscesses. Fistulas are a microscopic finding that helps physicians to distinguish Crohn disease from ulcerative colitis, the other type of inflammatory bowel disease. Obstetric fistulas frequently occur as a result of complications that arise during labour and cause a prolonged decrease in blood supply to the vagina and bladder or rectum. They occur also as a result of physical trauma sustained during sexual violence.
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Symptoms of fistula vary depending on location. Fistulas involving the gastrointestinal tract, bladder, or vagina may produce symptoms of diarrhea, bladder or bowel incontinence, dehydration, or abdominal pain. Symptoms of bronchopleural fistulas include cough and the production of yellowish or greenish sputum (purulent sputum). Arteriovenous fistula is associated with an aching pain in or beyond the area of the defect. Affected persons may have puffy legs that show distended veins, and a continuous heart murmur is often present, which may help in diagnosing and locating the fistula.
Although some fistulas may close on their own, others, including those involving the anus, bladder, or vagina, typically require surgical repair. Anal fistulas are often repaired through a procedure called fistulotomy, in which the passageway of the fistula is opened and combined with the anal canal. Fistulas of the vagina can be repaired by intravaginal surgery; in severe cases, reconstructive surgery is necessary to rebuild damaged tissues. Fibrin glue, which is typically made from the patient’s blood (autologous fibrin glue) and contains the clotting proteins fibrinogen and thrombin, is sometimes used to plug anal, gastrointestinal, and lung fistulas. Fibrin glue can be made from a donor’s plasma; however, the risk of disease transmission limits the utility of this approach. Untreated fistulas are associated with an increased risk for complications, including infection, skin irritation, kidney disease, ulcer, malnutrition, dehydration, incontinence, and neurological disease.