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Fistula


Presentation

  • They do not present the characteristic bilioptysis, but instead purulent bronchorrhea, fed by the hepatic abscess.[elsevier.es]
  • As previously mentioned, up to 50% of abscesses may re-present as another abscess or as a frank fistula.[fascrs.org]
  • These patients presented with high grade fever associated with rigors and sweating, some of them delirious.[ncbi.nlm.nih.gov]
  • Whenever the physician finds an abscess, and especially a fistula, further tests are needed to be sure Crohn’s disease is not present.[gicare.com]
  • […] blindly in perianal soft tissue (most commonly ischiorectal fossae) Multiple secondary openings may branch from primary opening Most common causes are Crohn's disease (complex fistulae with irregular edges), infections (tuberculosis [lung disease usually present[pathologyoutlines.com]
Falling
  • These cases of rupture of the duodenum, which are not true fistula, were caused by indirect violence inflicted on the abdomen, such as a kick from a horse, a fall, or a blow by being struck by a golf ball.[jamanetwork.com]
  • When the dead tissue falls away, she is left with a hole – a fistula, in medical terms – in the birth canal.[unfpa.org]
  • The dead tissue falls off resulting in a hole through which the woman continuously leaks urine or faeces or sometimes both. The tragedy of a fistula patient begins when she goes into labour. Try as she might, the baby won’t budge.[girlsnotbrides.org]
Chemosis
  • The medical terms for this are orbital proptosis (bulging), orbital chemosis (redness), and ocular hypertension (high pressure). Sometimes, the eye swells so quickly that there is no mistaking something very bad is happening.[med.nyu.edu]
Headache
  • […] the fistula are now closed (white arrows), so that all of fistulous blood is now directed into brain veins (blue arrows) Finally, many patients who have dural fistulas of all sizes and locations can have a myriad of symptoms such as different kinds of headache[med.nyu.edu]

Treatment

  • The treatment of perilymphatic fistula is an injection or surgery. While bed rest and nonsurgical treatment have been recommended as treatment of this condition, there is a risk of further deterioration of hearing and balance function.[ucihealth.org]
  • Following the diagnosis of a fistula, the medical professional will decide the best plan of treatment based on its location, size, and condition. One treatment path may simply be controlling symptoms with a catheter.[nafc.org]
  • TREATMENT OF ANAL FISTULA Currently, there is no medical treatment available for this problem and surgery is almost always necessary to cure an anal fistula.[fascrs.org]
  • […] reintegration of women who have received fistula treatment.[tostan.org]
  • A fistula or tract can take various forms, and the cause and location of the tract helps determine the best treatment method.[colgate.com]

Prognosis

  • Ultimately, prognosis is established individually based on the kind of fistula the patient has.[med.nyu.edu]
  • Prevention The prognosis for a dental fistula is typically very positive, provided you follow recommended treatment to eliminate the infection. Often, within a few months you won't even notice where the canal existed.[colgate.com]
  • […] opening on axial images use the "anal clock": anterior 12 o'clock identify secondary fistulous tracts and the sites of any abscess cavities in order to avoid therapeutic failure and recurrence cranial extension above the levator ani muscle Treatment and prognosis[radiopaedia.org]
  • Pseudoaneurysms and fistulas associated with endocarditis are infrequent entities, and patients only develop fistulas in 1.6% of cases. 3 The poor prognosis of these complications is a result of the associated severe valve deterioration; in this patient[revespcardiol.org]

Etiology

  • […] then submit the entire area of friability and ulceration to exclude dysplasia associated with inflammatory bowel disease Must sample ulcerated areas to exclude a rare malignancy Microscopic (histologic) description Histological features vary based on etiology[pathologyoutlines.com]
  • Etiology (why fistulas happen) The reason brain dural fistulas form is usually unclear. Sometimes, a patient has clear history of significant trauma or surgery in the area which later develops a fistula.[med.nyu.edu]
  • Discussion There are scarce reports of CMV esophagic fistulae in scientific literature, usually involving a multimicrobial etiology (generally in HIV positive patients) (3,4).[scielo.isciii.es]
  • Cryptoglandular fistula with Fournier's gangrene Fournier's gangrene, which was thought to be idiopathic by Jean Alfred Fournier (1883) is now known to have definite etiology and is characterized by obliterative endarteritis causing cutaneous and subcutaneous[ncbi.nlm.nih.gov]

Epidemiology

  • Fistula-in-ano in a defined population: incidence and epidemiological aspects. Ann Chir Gynaecol 1984; 73:219???224 [Google Scholar] 5. Sun MR, Smith MP, Kane RA.[ajronline.org]
  • Incidence and epidemiological aspects. Ann Chir Gynaecol. 1984. 73(4):219-24. [Medline]. Sun MR, Smith MP, Kane RA. Current techniques in imaging of fistula in ano: three-dimensional endoanal ultrasound and magnetic resonance imaging.[medscape.com]
  • Epidemiology [ edit ] A literature review published in 2018 showed an incidence as high as 21 people per 100,000.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 28. Lentz GM, Krane M. Anal incontinence: diagnosis and management.[medlineplus.gov]
  • The most commonly accepted pathophysiology is the cryptoglandular hypothesis, which posits that obstruction of the deep submucosal glands results in infection and abscess formation in the intersphincteric space, which consequently drains inferiorly between[radiopaedia.org]

Prevention

  • Ending obstetric fistula: Devastating and preventable childbirth injury continues to haunt women Ending obstetric fistula: Devastating and preventable childbirth injury continues to haunt women After decades of suffering, fistula survivors in Nepal find[endfistula.org]
  • Heller Fact 8: Training is critical Health professionals in afflicted countries are continuously being trained in preventing and managing obstetric fistula. WHO/P.[who.int]
  • Hamlin Fistula Ethiopia is a registered charitable organisation in Ethiopia dedicated to the treatment and prevention of childbirth injuries called obstetric fistulas.[hamlinfistula.org]
  • The prevention and treatment of obstetric fistula contribute to achieving Sustainable Development Goal 3, which is ensuring healthy lives; in this case, improving maternal health.[un.org]
  • However, the development of fistula can be prevented before medical intervention is necessary, before a woman is even pregnant, by delaying the age of her first pregnancy.[tostan.org]

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