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Anorectal Fistula

  • Rick Nelson
Chapter

Abstract

It is surprising that none of the quotes about the early use of the term fistula come from John of Arderne (1307–1392), whose classic work on the treatment of anal fistula is still in print, and who predates them all. It is possible that more has been written by surgeons about anorectal abscess and fistula than any other condition over the expanse of time and world geography [1–4]. Hippocrates (b. ∼460 BC) of course described the seton suture and Sushruta (b. ∼800 BC) described both fistulotomy and fistulectomy as well as the use of cauterizing chemicals in the fistula track. These treatments are still in common use (see below). This ongoing concern is a testament both to the prevalent nature of these disorders and the difficulty they present to the surgeon in basic decision making. The reasons for these difficult decisions are obvious. On the one hand, it is necessary to resolve sepsis and symptoms associated with it, principally pain, and yet the procedures that one employs must also preserve function in the anal canal, that is, prevent incontinence. Although surgeons have been treating anal fistulas for centuries, evidence supporting the effectiveness of these treatments is poor and scientific study scant (Box 4.1).

Keywords

Anal Canal Fibrin Glue Anal Fissure Anal Fistula Internal Opening 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  1. 1.Department of SurgeryNorthern General HospitalSheffieldUK

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