1. What is a fistula?
o Communication / abnormal relationship between the two hollow organs or hollow organ and the outside.

2. What causes it?
o Leakage anastomatic, trauma / injury to the bowels, chronic disease, inflammation / infection, abscesses, diverticulitis.

3. What complications may occur?
o Expenditure high fistula, malnutrition, skin problems, and patients who are not comfortable / pleasant.

4. What is perianal fistula?
o anal fistula from the rectum to the perianal skin.

5. What causes perianal fistula?
o It is usually caused by infection of anal glands.
o Usually perianus abscess caused by infected glands of analysts who mengerosi into the underlying tissue. Cultures of the fistula abscess anal rectum showed mixed infection with E.coli dominant.

6. What are the signs – the signs and symptoms?
o Flow perianal, perirectal swelling (perirectal abscess)
o dull pain in the rectum and mild systemic complaints continue to be a severe throbbing pain perianus accompanied by fever, chills and malaise.
o Redness, tenderness and protrusion of generalized into a common picture.

7. What happens when a chronic fistula occurred long?
o chronic fistula occurred a long time can degenerate into malignant carcinoma of the skin planoseluler.

8. What is produced on digital rectal examination?
o In general digital rectal fistula can be palpated between the forefinger in the anus (not rectum) and your thumb on the skin of the perineum as a rope as thick as approximately 3 mm (digital rectal bidigital)

9. What should be noted on the examination of perianal fistulas?
o Inspection must be equipped with rektoskopi to determine the presence of disease such as carcinoma of the rectum or proctitis tuberculosis, amoebic / morbus crohn.

10. What Goodsall’s legal?
o native fistula anterior to transfer the line will run straight through the rectum above and come out with more spending, while the rear has a first field cornering.

11. How Goodsall’s law can be remembered?
o Think of a dog with a straight nose and tail of the curve.

12. Located where the mensekrasi mucus glands?
o-secreting anal glands are located in the submucosal intestine, in muscles and between the longitudinal muscle layer and circulation, and is associated with anal canal through ducts are long and narrow.

13. What happens in chronic fistel long?
o Fistel chronic ages can be susceptible to malignant degeneration planoseluler carcinoma of the skin.

14. Call and explain the differential diagnosis of perianal fistula!
o Hidradenitis supurativa an inflammation of apocrine sweat glands which usually form multiple subcutaneous fistula is occasionally found in the armpits and generally does not extend to the deeper structures.
o Sinus pilonidalis sakrokoksigeal there are only in the folds derived from the nest and the dorsal hair of koksigeus bone or bone end of the sacrum

15. Fistel proctitis can occur in?
o Fistel proctitis can occur in morbus Crohn’s, tuberculosis, amubiasis, fungal infections, and diverticulitis.

16. In as much as possible done fistulotomi fistula. The point is?
o fistel means of an aperture is opened up kelubang skin origin. The wound was left open so that the healing started from the basic per sekundam intentionem. The wound will heal in time is usually rather short. Sometimes dibuthkan two-stage operation to avoid the anal sphincter terpotongnya.

17. What can cause recurrent fistulas?
o fistula can recur if the holes do not participate in the opened or removed, the fistula did not contribute to open branches, or skin wound was closed before reaching the surface of granulation tissue.

18. Mention how perianal fistula prevention!
o At the fistula can be done fistulotomi or fistulektomi.

19. When and for what is needed use a ton yells?
o The use of loose Setons is required at a high level of fistulas (ie, trans-sphincteric and suprasphincteric) to reduce the risk of incontinence or in the case of poor wound healing is anticipated. A Seton is a nonabsorbable nylon suture or silk That is guided through the fistula tract and tied suture placement exteriorly to maintain within the tract and to cause compression of the tract. A Seton are nonabsorbable nylon or silk suture is guided through a brochure and fistula exteriorly bound to keep the suture placement in the book and cause compression of the book

20. What happens when a surgical therapy be delayed?
o result in further tissue damage due to an abscess anorektum should be considered an emergency.
o The expansion of multilateral cooperation may extend into the thigh, scrotum and even the abdominal wall.

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