A fistula in ano is a track, lined by infective tissue which connects deeply from the anal canal or rectum to the skin superficially. It usually results from the bursting or surgical drainage of a perianal abscess. These fistulae may at times be found in association with specific conditions like Crohn’s disease, tuberculosis or rectal malignancies.

Patients usually present with intermittent purulent or bloody discharge, sometimes a painful swelling at the external opening which is painful, till it ruptures and discharges pus. The pain subsides after this and subsequently, the cycle repeats itself.

Clinical examination done in a thorough manner is very essential for the diagnosis. This can be helped by a Magnetic resonance Imaging (MRI) examination. This shows the exact site of the internal opening and helps in delineating the tract.

Fistulas do not heal spontaneously or only with medication. They need to be operated.

The procedures done are :

• Fistulotomy
• Fistulectomy
• Seton application