This is again a common but at times a complex entity. It generally presents after a perianal abscess or boil has ruptured. The patient presents to the surgeon with a small single or multiple opening around the anus, which intermittently drains pus. There can be pain especially if the opening has got blocked and pus starts collecting inside. It essentially involves a communication between the rectum or anal canal with the external perianal skin.
Fistulas should be evaluated with an MRI scan to map the exact type and course of the tract.
Treatment of most fistulas is surgery or some modification there off. Simple fistulas involve removal of the tract. In complex and high fistulas special techniques like seton placement or anal plug placement or VAAFT is used. All these procedures are again done as day care procedures and do not require hospital stay.
Most of these procedures are painless with early joining back to work.