This is again a common but at times a complex entity. It generally happens after a
perianal abscess or boil has ruptured. The patient reports to the surgeon with small
single or multiple openings around the anus, which intermittently drains pus. There
can be much 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
Treatment of most fistulas is surgery or some modification thereof. 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 a hospital stay.
Most of these procedures are painless with early joining back to work.