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Surgery diseases >>>> What is a fistula?

What is a fistula?

A fistula is a narrow canal that connects organ cavities or interstitial cavities to each other or to the external environment. This is a pathological formation that looks like a tube and consists of granulation tissue or epithelium.

A fistula is formed as a result of the fact that the purulent exudate accumulating in the focus of inflammation begins to make its way to exit.

The causes of fistula formation (fistulas) are associated with poorly healing wounds, including those of surgical origin. Slowed tissue regeneration processes, improper wound treatment, reduced immune reactions lead to the fact that purulent inflammation does not dissolve under the influence of immune agents or drug therapy and expands its boundaries not according to the principle of diffuse inflammation (for example, phlegmon), but according to the principle of forming an additional channel for movement of purulent masses.

Internal fistulas are often formed due to obstruction of the esophagus, bronchi, intestines, kidneys, bladder, for example, food pieces, calculi.

What does a fistula look like? An external fistula is noticeable even for a non-professional look: a depression like a funnel appears on the surface of the skin (the diameter of the funnel can be different) with a hole. From the hole, depending on where the fistula originates from, air, liquid (mucus, saliva, gastric juice, urine, purulent mixture, etc.), feces (with intestinal fistula), food masses (gastric fistula), bronchial mucus (lung fistula). The surface of the skin at the site of the fistula outlet can be irritated by constant exposure to the secreted fluid and become infected.

Treatment of a fistula depends on its location. For internal fistulas, surgical treatment is indicated by removing the focus of inflammation and the formed tubular passage, suturing the hole. With external fistulas, in addition to the surgical method, it is possible to use the treatment of the fistula with proteolytic enzymes and antiseptics, cauterization with iodine solution. Thus, they stimulate regenerative processes, carry out an antiseptic of the wound and achieve the collapse of the fistulous passage. The chosen method of treating a fistula depends on its depth, diameter, and the organ in which the fistula originated.


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