Understanding Fistulae: Types, Causes, and Treatment Options
Fistulae (plural of fistula) are abnormal connections between two organs or between an organ and the skin that can cause a variety of health problems. Fistulae can be congenital (present at birth) or acquired through injury, infection, or disease.
There are many different types of fistulae, including:
1. Anal fistulae: These are common in people with inflammatory bowel disease, such as Crohn's disease or ulcerative colitis. They form when an abscess (a collection of pus) develops near the anus and creates a tunnel-like connection to the skin around the anus.
2. Rectovaginal fistulae: These occur when there is a connection between the rectum and the vagina, often due to radiation therapy for cervical cancer or other forms of pelvic radiation.
3. Enterocutaneous fistulae: These form when there is a connection between the intestine and the skin, often as a result of inflammatory bowel disease or diverticulitis (a condition in which small pouches form in the wall of the colon).
4. Urogenital fistulae: These occur when there is a connection between the urinary tract and the vagina or skin, often due to injury or surgery.
5. Cerebrospinal fluid (CSF) fistulae: These form when there is a connection between the brain and the nose or sinuses, often as a result of a head injury or infection.
6. Gastrointestinal fistulae: These occur when there is a connection between the gastrointestinal tract and another organ or the skin, often due to inflammatory bowel disease or other conditions such as diverticulitis or cancer.
7. Pancreatic-biliary fistulae: These form when there is a connection between the pancreas and the bile ducts, often as a result of pancreatitis (inflammation of the pancreas) or surgery.
8. Hepato-enteric fistulae: These occur when there is a connection between the liver and the intestine, often due to inflammatory bowel disease or other conditions such as cirrhosis (scarring of the liver).
9. Portocaval fistulae: These form when there is a connection between the portal vein (which carries blood from the digestive organs to the liver) and the caval vein (which carries blood from the lower body to the heart), often as a result of liver disease or surgery.
Fistulae can cause a range of symptoms, including:
* Infection
* Abscesses
* Fever
* Pain
* Discharge or leakage of fluid
* Bad smell
* Incontinence
* Diarrhea
* Constipation
Treatment for fistulae depends on the type and location of the fistula, as well as the underlying cause. Treatment options may include:
1. Antibiotics to treat infection
2. Surgery to repair or close the fistula
3. Drainage of abscesses
4. Changes to diet or bowel habits
5. Use of stomas (artificial openings) to divert flow away from the fistula
6. Use of setons (small tubes) to drain fluid from the fistula
7. Use of fistulography (a specialized X-ray technique) to visualize the fistula and plan treatment.
It is important to seek medical attention if you suspect that you have a fistula, as untreated fistulae can lead to serious complications such as infection, abscesses, and organ damage.
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