

Anal fistula are "tunnels" that connect the skin surface around the anal margin to the anal canal. These tunnels can be of varying length and involve the anal sphincter muscle. Untreated, when the tunnels become infected, this can result in repeated inflammation and infection in the fatty tissue surrounding the anus. There will usually be pain and purulent discharge during these periods. Solving the problem requires accurate identification of the origin and termination of these tunnels. Endoanal ultrasound and MRI ( magnetic resonance imaging) allows accurate diagnosis and mapping.
One of the main problems facing surgery is the involvement of the anal sphincter. If a large extent is involved, then a staged procedure requiring the use of an inert drain may may required - "seton". Otherwise, laying open the fistula in low openings results in the best cure. Other novel techniques currently employed include VAAFT (Video Assisted Anal Fistula Treatment) or LIFT (Ligation of Fistula Tract)