Fistula: abnormal channels between organs, vessels, or body surfaces

Types and characteristics

Common categories of fistula include:

• Enterocutaneous — between intestine and skin.
• Enteroenteric or enterocolic — between segments of bowel.
• Anal and perianal — often related to anal glands and inflammatory bowel disease.
• Rectovaginal — between rectum and vagina.
• Arteriovenous (AV) — connecting an artery and a vein; these can be pathological or surgically created for dialysis access.

Causes, symptoms and diagnosis

Fistulas form for multiple reasons: penetrating injury, postoperative complications, persistent infection, inflammatory diseases such as Crohn's disease, radiation damage, childbirth trauma and certain cancers. Symptoms depend on location and may include persistent drainage, abnormal passage of stool or urine, bleeding, pain, swelling or systemic infection. Medical evaluation commonly uses physical examination, endoscopy, ultrasound, CT or MRI and contrast studies such as fistulography to define the tract.

Treatment and outcomes

Management is tailored to the type and cause. Conservative measures include wound care, antibiotics and nutritional support. Immunosuppressive therapies (for inflammatory causes) or biologic drugs can help close inflammatory fistulas. Many fistulas require surgical repair: options include incision and drainage, seton placement, fistulotomy, flap repair, resection of diseased bowel, or creation of a protective stoma. Surgically created AV fistulas are intentionally formed to permit long-term hemodialysis access and are distinct from disease-associated fistulas.

History, terminology and notable points

The term derives from a Latin word meaning "tube" or "pipe," reflecting the channel-like nature of the lesion. In everyday clinical practice the word "fistula" is used broadly; clinicians distinguish between congenital and acquired fistulas and between those created therapeutically and those that are pathologic. Untreated fistulas can lead to chronic infection, skin breakdown, malnutrition or sepsis, so prompt diagnosis and an appropriate multidisciplinary plan are important.

Further reading and references

For brief pointers and background see sources on etymology, the original Latin sense of the word, and its meaning as "pipe" or "tube" in older texts (pipe). Medical definitions and clinical overviews appear in standard references (medical) describing an abnormal connection between structures such as blood vessels, intestines or other hollow organs. Common causes include injury, postoperative complications or surgery, as well as infection and chronic inflammation. Clinically, a fistula is considered a pathological condition unless intentionally created for therapy.