A study on clinicopathology of fistula in ano

Emil Phinehas, Mayandi Parimala, Jeyaraj Ravishankar


Background: Perianal fistula is a common surgical problem which poses great discomfort to patients and causes prolonged morbidity when improperly managed or developed complications. Its management protocols are ill defined, and the efficacy of newer treatment modalities are not well established. The aim of the study was to study the clinicopathology of Perianal fistula and its prognostic factors.

Methods: This was a prospective study conducted at the Department of General Surgery, Rajiv Gandhi Government General Hospital between August 2014 and July 2015. Purposive sampling method was used select patients with fistula in ano. After obtaining informed consent, patient details were collected in pre-tested structured questionnaire. Data entry and analysis were done using SPSS software.

Results: Males between thirty and fifty years were the most affected population. Most of the patients had no co-morbidities while Diabetes Mellitus was the prevalent co-morbid factor, seen especially in the elderly. MRI fistulogram was the investigation of choice. Fistulotomy was the preferred procedure. Recurrence of fistula was an unavoidable morbidity.

Conclusions: Proper preoperative evaluation which includes MRI fistulogram and planning the treatment is essential to prevent complications. Fistulotomy is the preferred treatment especially in patients with trans-sphincteric fistula and those with evidence of infection or secondary tract.  The prognosis, if properly managed is very good, so proper management protocols need to be established.


Fistulo in ano, Fistulotomy, MRI fistulogram

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