A fistula is an abnormal connection between an organ, vessel, or intestine and another structure. Fistulas are usually the result of injury or surgery. It can also result from infection or inflammation.
Inflammatory bowel disease, such as ulcerative colitis or Crohn's disease, is an example of a disease that leads to fistulas between one loop of intestine and another. Injury can lead to fistulas between arteries and veins.
Fistulas may occur in many parts of the body. Some of these are:
- Arteriovenous (between an artery and vein)
- Biliary (created during gallbladder surgery, connecting bile
ducts to the surface of the skin)
- Cervical (either an abnormal opening into the cervix
or in the neck)
- Craniosinus (between the space inside the skull and a nasal sinus)
- Enterovaginal (between the bowel and vagina
- Fecal or anal (the feces is discharged through an opening other than the anus)
- Gastric (from the stomach to the surface of the skin)
- Metroperitoneal (between the uterus and peritoneal cavity)
- Pulmonary arteriovenous
(in a lung, the pulmonary artery and vein are connected, allowing the blood to bypass the oxygenation process in the lung)
- Umbilical (connection between the navel and gut)
Types of fistulas include:
- Blind (open on one end only, but connects to two structures)
- Complete (has both external and internal openings)
- Horseshoe (connecting the anus to the surface of the skin after going around the rectum)
- Incomplete (a tube from the skin that is closed on the inside and does not connect to any internal structure)
Minei JP,Champine JG. Abdominal abscesses and gastrointestinal fistulas. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 26.
Lentz GM. Anal incontinence. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL. eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 22.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.