Clinical presentation and outcome of fistula in ano cases


  • Shruti Yadu Department of General Surgery, Government Medical College, Rajnandgaon, Chhattisgarh, India
  • Aradhana Toppo Department of General Surgery, Government Medical College, Rajnandgaon, Chhattisgarh, India



Fistula-in-ano, Fistulectomy, Peri-anal disorder


Background: Fistula-in-ano is an abnormal communication between the anal canal or rectum and the perianal skin, which causes a chronic inflammatory response. The most common cause is nearly always by a previous anorectal abscess. The chief complaint of anorectal fistula is intermittent or constant drainage or discharge. There is usually a history of previous pain, swelling and recurrent abscess that ruptured spontaneously or was surgically drained. There may be a pink or red elevation exuding pus, or it may have healed. Digital rectal examination remains the main stay of diagnosis in anorectal fistula cases.

Methods: The present cross sectional observational prospective study was conducted in 50 patients who presented with their complaints to the Surgery Outpatient Department and who were admitted under the Department of Surgery, Dr. B.R.A.M. Hospital, Raipur (C.G.), India during study period was from March 2015 to September 2016. Detailed clinical history and examination of the patient was recorded. All investigations relevant to the study were done in all the patients. Appropriate surgical management were performed. Postoperative findings were noted.

Results: 36% patients are in the age group of 41-50. 82% are male patients and 18% patients are female patient. 76% Patients had single opening. 74% Patients had perianal discharge while 66% patients presented with perianal pain. 40% patients had h/o perianal abscess. Most common mode of presentation was discharge. 76% patients had posterior opening while 24% patients had anterior opening. Fistulectomy and fistulotomy were performed in 39 subjects (78%) and 7 subjects (14 %) respectively.

Conclusions: Anal fistula is a common disease which is devastating to the patients and imposes challenges to the surgeon. Early diagnosis and appropriate management are the key to success.


Deeba S, Aziz O, Sains PS, Darzi A. Fistulain-ano: advances in treatment. Am J Surg. 2008;196(1):95-9.

Babu AK, Naik MB, Babu MR, Madhulikia M. Seton - as a gold standard treatment for high fistula in ano. J Evidence Based Med Healthcare. 2015;2(11):1687-93.

Russel TR. Anorectum. In: Lawrence W, eds. Current surgical diagnosis and treatment. 10th edition. McGraw-Hill Companies; 1994.

Adams D, Kovalcik PJ. Fistula in ano. Surg Gynecol Obstet. 1981;153:731-2.

Gupta PJ. Frequency fistulotomy: a better tool radio frequency fistulotomy: a better tool than the conventional techniques in anal fistula. Indian J Surg. 2006;68:48-52.

Isbister WH. Fistula in ano: a surgical audit. International J Colorectal Dis. 1995;10(2):94-6.

Parks AG. Pathogenesis and treatment of fistuila-in-ano. Br Med J. 1998;1(5224):463-9.

Panda UN. Current medical diagnosis and treatment. Jaypee Brothers Publishers; 2002.

Vasilevsky CA, Gordon PH. Benign anorectal: Abscess and Fistula. The ASCRS textbook of colon and rectal surgery. New York, NY: Springer; 2007:192-214.

Siddharth R, Kumar GA, Sreedhar S. Clinical study of fistula in ano. J Evol Medical Dent Sci. 2015;4(86):15082-87.

Sainio P. Fistula-in-ano. Clinical features and long-term results of surgery in 199 adults. Ann Chir Gynaecol. 1985;151(2):169-76.

Hamadani A, Haigh PI, Liu IL, Abbas MA. Who is at risk for developing chronic anal fistula or recurrent anal sepsis after initial perianal abscess? Dis Colon Rectum. 2009;52(2):217-21.

Kumar VH, Chetan PR, Naveen PR. A clinico-pathological study of fistula-in-ano. Sch J App Med Sci. 2015;3(3F):1471-76.

Kim JW, Kwon SW, Son SW, Ahn DH, Lee KP. Comparative review of perianal sinus and fistula in ano. J Korean Soc Coloproctol. 2000;16(1):7-11

Rotstein OD, Pruett TL, Simmons RL. Mechanisms of microbial synergy in polymicrobial surgical infections. Rev Infect Dis. 1985;7(2):151-70.

Thwaini A, Khan A, Malik A. Fournier’s gangrene and its emergency management. Postgrad Med J. 2006;82(970):516-9.

Marks CG, Ritchie JK. Anal fistulas at St. Mark’s Hospital. Br J Surg. 1977;64:84-91.






Original Research Articles