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Location of fistulasFistulas can develop in various parts of the body, including the following (sorted by the International Statistical Classification of Diseases and Related Health Problems):it is a very serious and painful disorder that most commonly occurs in people of third world or poorer countries. H: Diseases of the eye, adnexa, ear, and mastoid process
I: Diseases of the circulatory system
J: Diseases of the respiratory system
K: Diseases of the digestive systemImage:Duodeno Biliary Fistula 08786.jpg Duodeno Biliary Fistula
M: Diseases of the musculoskeletal system and connective tissue
N: Diseases of the genitourinary system
Q: Congenital malformations, deformations and chromosomal abnormalities
T: External causes
Types of fistulas
Although most fistulas are in forms of a tube, some can also have multiple branches. CausesVarious causes of fistula are:
TreatmentTreatment for fistulae varies depending on the cause and extent of the fistula, but often involves surgical intervention combined with antibiotic therapy.
In some cases the fistula is temporarily covered, for example a fistula caused by cleft palate is often treated with a palatal obturator to delay the need for surgery to a more appropriate age. Surgery is often required to assure adequate drainage of the fistula (so that pus may escape without forming an abscess). Various surgical procedures are commonly used, most commonly fistulotomy, placement of a seton (a cord that is passed through the path of the fistula to keep it open for draining), or an endorectal flap procedure (where healthy tissue is pulled over the internal side of the fistula to keep feces or other material from reinfecting the channel). Treatments involving filling the fistula with fibrin glue or plugging it with plugs made of porcine small intestine submucosa have also been explored in recent years, with variable success. Surgery for anorectal fistulae is not without side effects, including recurrence, reinfection, and incontinence. It is important to note that surgical treatment of a fistula without diagnosis or management of the underlying condition, if any, is not recommended. For example, surgical treatment of fistulae in Crohn's disease can be effective, but if the Crohn's disease itself is not treated, the rate of recurrence of fistula is very high (well above 50%). Kshar sutra Therapy is non-operative and belongs to the Para surgical group of measures with nil recurrence rate of disease. It involves the application of a specially prepared medicated thread processed with certain vegetable caustics. The thread is passed into the fistulous tract, tied outside the anal aperture and left in situ for seven days after which it is changed and retied. The patient is sent home after every sitting and is advised to continue his routine work as usual. In due course of time , the thread falls out spontaneously and the fistulous track is simultaneously healed. The resultant scar formation is very minimal and the method is safe and free from any complications. [citation needed] Therapeutic useIn end stage renal failure patients, a cimino fistula is often deliberately created in the arm by means of a short day surgery in order to permit easier withdrawal of blood for hemodialysis. See also
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