Perianal fistula
A perianal fistula is a tubelike chronic ulcer in the anal region which originates within the mucous membrane of the anus. When an inflammation occurs here, an abcess may form. When this abess finds its way out to the skin in the anal region, a fistula may result.
1
2
On photograph 1 the opening of the fistula is in fact hardly seen, but on no. 2 a probe can be effortlessly put into the fistula and the anal mucous membrane.
3
4
5
To obtain healing, the fistula has to be opened. On photograph 3 and 4 for this an electric knife is used for cleavage of the skin and to obtain hemostasis. On photograph 5 a part of the fistula floor is still visible. It is not always necessary to remove this, especially if one is afraid to jeopardize the faecal continence.
6
The open wound that is the result of the intervention (6) generally heals within a couple of weeks. In this example on request of the patient also a piece of redundant skin has been removed so that the wound is larger than would have been necessary for the fistula only.