Fistula – Symptoms And Causes
Write short note on sinus and fitula.
Or
Write short answer on sinus and fitula.
Answer.
Sinus
- It is a blind tract leading from the surface down into the tissues.
- It is lined with a granulation tissue.
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Causes Of Sinus
- Congenital sinus: Preauricular sinus.
- Acquired sinus:
- Median mental sinus: Occurs as a result oftooth abscess.
- Pilonidal sinus: Occurs in the midline in the anal region.
- Osteomyelitis: Gives rise to sinus discharging pus with or without bony spicules.
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Fistula
It is an abnormal communication between the lumen of one viscus and the lumen of another (internal) or communication of one hollow viscus withthe exterior, i.e. body surface (external fitula).
- Examples ofinternal fitula:
- Tracheoesophageal fitula
- Colovesical fitula
- Examples of external fitula
- Orocutaneous fitula due to carcinoma of the oral cavity infitrating the skin
- Branchial fitula
- Thyroglossal fitula.
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Clinical Features of Sinus/Fistula
- Discharge from the opening of sinus
- No flor is present
- Raised indurated edge, indurated base and non-mobile
- Often sprouting granulation tissue over sinus opening.
- Bone thickening in osteomyelitis
- Surrounding skin may be erythematous and inflmmatory.
- Bluishin tuberculosis, excoriated in fecal fitula, pigmented in chronic sinuses and fitulas.
- Induration is the feature of all chronic fistulas except tuberculosis.
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Investigations
- Fistulogram/Sinusogram using ultraflid lipiodol or water soluble iodine dye.
- Biopsy from edge for tuberculosis and malignancy
- X-ray of the involved part.
- Proctoscopy of fistula.
Treatment
- Cause should be treated
- Excision of sinus or fitula and specimen should be sent for histology
- Antibiotics, anti-tubercular drugs, rest and adequate drainage.
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