A fistula is an abnormal tube-like
connection occurs between two organs or vessels that are lined with epithelial
cells. Fistulas are normally caused by injury or surgery, but they can also
result from an infection or inflammation. Fistulas are disease condition, but
they may be surgically created for therapeutic reasons.
There are three common types of Fistula; Arteriovenous fistula, Anal fistula and Obstetric fistula.
Most of these fistulas are in forms of a tube, some can also have multiple
branches, also they are formed between the end of the bowel and skin near the
anus (anal fistula) or between the intestine and the vagina (Obstetric
fistula). These two fistulas (Anal & Obstetric fistula) are termed Natural
fistula.
Sometimes artificial fistula may
be created, for example, between an artery and vein (arteriovenous fistula)
when a person needs renal dialysis. An arteriovenous fistula may also be caused
by injury.
The following are more descriptions about the most common
types of fistula together with their causes and treatment.
A. ARTERIOVENOUS FISTULA
Is an abnormal connection between
an artery and a vein. These connection are congenital; can occur at any point
in the vascular system; and vary in size, length, location, and number.
Usually, blood flows from your arteries to your capillaries to your veins.
Nutrients and oxygen in your blood travel from your capillaries to tissues in
your body.
This kind of fistula cause blood
flows directly from an artery into a vein, bypassing some capillaries. When
this happens, tissues below the bypassed capillaries receive a diminished blood
supply.
An arteriovenous fistula may
develop as a complication of a process known as cardiac catheterization.
Cardiac catheterization is the insertion of a catheter into a chamber or vessel
of the heart. This is done both for diagnostic and interventional purposes.
Skin piercing injury, such as a
gunshot or stab wound my develop arteriovenous fistula. This will happen if the
piercing part of your body has side by side blood capillaries (Vein and Artery)
Sometimes Arteriovenous fistula my
happen as an inborn disesase, probably due to the facts that the arteries and
veins don't develop properly in the womb.
TREATMENT
1. Surgery
The type of your surgery will
depends on the size and location of your arteriovenous fistula. Surgery can be
an effective method for correcting complex congenital arteriovenous
malformations, especially in the lower limbs.
2. Catheter embolization
A catheter is a thin tube made from
medical grade materials serving a broad range of functions. They are medical
devices that can be inserted in the body to treat diseases or perform a
surgical procedure
Embolization is an invasive
treatment (minimal) that blocks one or more blood vessels or vascular channels
of abnormalities.
Catheter embolization is a process
of applying medications or synthetic materials called embolic agents through a
catheter into a blood vessel to block blood flow to an area of the body.
3. Ultrasound-guided compression
In this treatment, an ultrasound
probe is used to compress the fistula and block blood flow to the damaged blood
vessels. This procedure only takes about 10 minutes. But it only works for
about one in three people.
SYMPTOMS
1. Decreased blood pressure
2. Fatigue
3. Heart failure
4. Swelling in the arms or legs
5. Purplish, bulging veins that
you can see through your skin, similar to varicose veins.
NB:
The above symptoms are just few,
there might be more other symptoms.
B. ANAL FISTULA
Is the development of small
channel between the end of the bowel and the skin near the anus, fistula can
occur after surgery to drain an anal abscess. It can cause bleeding and
discharge when passing stools - and can be painful.
Anal fistulas can cause discomfort
and skin irritation, and won't usually get better on their own. Is the result of an infection near the
anus causing a
collection of pus (abscess) in the nearby tissue. When the pus drains away, it
can leave a small channel behind.
During the final stage of fistula
you might see the visible hole in the skin near your anus, although this may be difficult for you to
see yourself.
The most causes of anal fistulas
is by anal abscess, This happen if the abscess doesn't heal properly after the
pus has drained away. It's estimated that between one in every two to four people with an anal abscess will
develop a fistula.
SYMPTOMS
1. Smelly discharge from near your anus
2. Passing pus or blood when you defecate.
3. Swelling and redness around your
anus and a high temperature.
4. Skin irritation around the anus
5. A constant, throbbing pain that
may be worse when you sit down, move around, have a bowel movement or cough.
NB:
The above symptoms are just few,
there might be more other symptoms.
TREATMENT
Kind of treatment will depend on the position
of your fistula and whether it's a single channel or branches off in different
directions. Surgery is only the best treatment for anal fistula as very few heal by
themselves.
C. OBSTETRIC FISTULA
Is a hole between the vagina and
rectum or bladder that is caused by prolonged obstructed labor, leaving a woman
incontinent of urine or feces or both. Is the most worse and serious of all
childbirth injuries.
The Obstructed labor can last up
to six or seven days, which produces contractions that push the baby's head
against the mother's pelvic bone. The soft tissues between the baby’s head and the pelvic bone are
compressed and do not receive adequate blood flow. The lack of blood flow
causes this delicate tissue to die, and where it dies holes are created between
the laboring mother’s
bladder and vagina and/or between the rectum and vagina.
Obstetric fistula is more common
when adequate medical care is not available, is considered a disease of
poverty. An obstetric fistula is almost entirely preventable. According to
health advocates, its persistence is a sign that health systems are failing to
meet women’s essential needs.
SYMPTOMS
1. Flatulence, urinary or fecal
incontinence, which may be continual
2. Repeated vaginal or urinary
tract
3. Foul-smelling vaginal
4. Irritation or pain in the
vagina or surrounding areas.
NB:
The above symptoms are just few,
there might be more other symptoms.
TREATMENT
Surgery is the best treatment of
Obstetric fistula, though before that you must see your doctor for examination,
if there is the need to heal the wounds first or not. Also this kind of fistula
can be prevented by ensuring availability of medical care during women labor.
Treatment for fistula varies
depending on the cause and extent of the fistula, but often involves surgical
intervention combined with antibiotic therapy. It is important to see your
doctor first for examination before treating a fistula so as to determine the
extent and "path" that the fistula takes through the tissue.
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