Chapter 12 Anorectal Fistula
INTRODUCTION
Description: An anorectal fistula involves communication between the anal or rectal canal and the perineum.
ETIOLOGY AND PATHOGENESIS
Causes: Anorectal fistulae may arise spontaneously or result from the drainage of a perirectal abscess. Patients with anal fistulae should be evaluated for the possibility of inflammatory bowel disease.
Risk Factors: Although Crohn’s disease and tuberculosis are recognized risk factors, in most patients a predisposing cause is not apparent. Other risk factors include tears, puncture wounds, and internal hemorrhoids; less commonly carcinoma, radiation therapy, actinomycoses, tuberculosis, and chlamydial infections increase risk.
