fistula /fis·tu·la/ (fis´tu-lah) pl. fistulas, fis´tulae [L.] an abnormal passage between two internal organs or from an internal organ to the body surface. 
fistula [fis´tu-lah] (pl. fistulas, fis´tulae) (L.)
)
Various types of fistulae, designated according to site or to the organs with which they communicate. (A), Genitourinary fistulae; (B), anal fistulae.
anal fistula one from the anus to the skin, sometimes communicating with the rectum.
arteriovenous fistula
1. one between an artery and a vein.
2. a surgically created arteriovenous connection that provides a site of access for hemodialysis tubing.
blind fistula one open at one end only, opening on the skin (external blind f.) or on an internal mucous surface (internal blind f.) .
branchial fistula a persistent pharyngeal groove (branchial cleft).
cerebrospinal fluid fistula one between the subarachnoid space and a body cavity, with leakage of cerebrospinal fluid, usually as otorrhea or rhinorrhea.
colonic fistula one connecting the colon with the body surface or another organ.
craniosinus fistula one between the cerebral space and one of the sinuses, permitting escape of cerebrospinal fluid into the nose.
enterovesical fistula one connecting the urinary bladder with some part of the intestines.
fecal fistula a colonic fistula that discharges feces on the body surface.
gastric fistula one communicating with the stomach, either pathologically or surgically created through the abdominal wall.
genitourinary fistula one between two organs of the urogenital system or between one of those organs and some other system.
incomplete fistula blind f.
intestinal fistula one communicating with the intestine; sometimes surgically created through the abdominal wall.
perilymph fistula rupture of the round window with leakage of perilymph into the middle ear, causing sensorineural hearing loss.
pulmonary arteriovenous fistula a congenital fistula between the pulmonary arterial and venous systems, so that unoxygenated blood enters the systemic circulation.
salivary fistula one communicating with a salivary duct.
tracheoesophageal fistula one connecting the trachea and esophagus, either pathologically or created surgically to restore speech after laryngectomy.
umbilical fistula one communicating with the colon or the urachus at the umbilicus.
fistula [fis´tu-lah] (pl. fistulas, fis´tulae) (L.)
any abnormal tubelike passage within body tissue, usually between two internal organs or leading from an internal organ to the body surface. Some fistulas are created surgically for diagnostic or therapeutic purposes; others occur as result of injury or as congenital abnormalities. Among the many kinds of fistulas, the anal type (fistula in ano) is one of the most common. It generally develops as a result of a break or fissure in the wall of the anal canal or rectum, or an abscess there. Treatment is by surgery.
In women, difficult labor in childbirth may result in formation of a vesicovaginal fistula between the bladder and the vagina with resulting leakage of urine into the vagina. In a vesicointestinal fistula, there is leakage of urine from the bladder into the intestine. In a rectovaginal fistula, feces escape through the wall of the anal canal or rectum into the vagina. This condition, formerly a serious hazard of childbirth, is now rare; like other kinds of fistula, it can be corrected by surgery.
With the types of fistulas described here, typical symptoms are pain in the affected region and an abnormal discharge through the skin near the anus or through the vagina. Fistulas at different places of the body may be caused by tuberculosis, actinomycosis (a fungus infection), the presence of diverticula, or certain other serious diseases, and the fistula itself may be a site of infection and discomfort.
In women, difficult labor in childbirth may result in formation of a vesicovaginal fistula between the bladder and the vagina with resulting leakage of urine into the vagina. In a vesicointestinal fistula, there is leakage of urine from the bladder into the intestine. In a rectovaginal fistula, feces escape through the wall of the anal canal or rectum into the vagina. This condition, formerly a serious hazard of childbirth, is now rare; like other kinds of fistula, it can be corrected by surgery.
With the types of fistulas described here, typical symptoms are pain in the affected region and an abnormal discharge through the skin near the anus or through the vagina. Fistulas at different places of the body may be caused by tuberculosis, actinomycosis (a fungus infection), the presence of diverticula, or certain other serious diseases, and the fistula itself may be a site of infection and discomfort.
abdominal fistula one between a hollow abdominal organ and the surface of the abdomen.
anal fistula (fistula in a´no) one opening on the cutaneous surface near the anus, which may or may not communicate with the rectum.
arteriovenous fistula one between an artery and a vein, either pathologic (such as a varicose aneurysm) or surgically created to ensure an access site for hemodialysis. The site must be allowed 6 to 8 weeks to mature before it can be cannulated. Such a fistula may be the anastomosis of a natural artery and vein, a bovine graft, or a synthetic polytetrafluoroethylene (PTFE) graft. The bovine graft is taken from the bovine carotid artery and anastomosed to the vein and artery of the patient. In a PTFE graft, fibers are woven into a mesh called Gore-Tex and made into a sleeve and flange; this is available in a variety of sizes.
Precautions necessary to insure patient safety when caring for an individual with an arteriovenous fistula include frequent assessments for adequate circulation in the fistula and the distal extremity. A bruit or thrill can be heard over the access site. Blood pressure measurements, withdrawal of blood, injections, and administration of intravenous fluids should not be done on the extremity with such a fistula.
Precautions necessary to insure patient safety when caring for an individual with an arteriovenous fistula include frequent assessments for adequate circulation in the fistula and the distal extremity. A bruit or thrill can be heard over the access site. Blood pressure measurements, withdrawal of blood, injections, and administration of intravenous fluids should not be done on the extremity with such a fistula.
Internal arteriovenous fistulas.
blind fistula one open at one end only, opening on the skin (external blind fistula) or on an internal surface (internal blind fistula).
branchial fistula a persistent pharyngeal groove (branchial cleft).
Brescia-Cimino fistula an arteriovenous fistula for hemodialysis access, connecting the cephalic vein and radial artery.
bronchopleural fistula one between a bronchus and the pleural cavity, causing an air leak into the pleural cavity; sometimes seen as a complication of empyema, fibrosis, or pneumonia.
cerebrospinal fluid fistula one between the subarachnoid space and a body cavity, such as from head trauma or bone erosion, with leakage of cerebrospinal fluid, usually in the form of rhinorrhea or otorrhea.
complete fistula one extending from the skin to an internal body cavity.
craniosinus fistula one between the cerebral space and a paranasal sinus, permitting escape of cerebrospinal fluid into the nose.
Eck's fistula an artificial communication made between the portal vein and the vena cava.
enterocutaneous fistula see enterocutaneous fistula.
enterovesical fistula one connecting some part of the intestine with the urinary bladder; called also vesicoenteric f.
fecal fistula one between the colon and the external surface of the body, discharging feces.
gastric fistula
1. one communicating between the stomach and some other body part.
2. a passage created artificially through the abdominal wall into the stomach.
horseshoe fistula one near the anus, having a semicircular tract with both openings on the skin.
incomplete fistula blind fistula.
perilymph fistula rupture of the round window with leakage of perilymph into the inner ear, so that changes in middle ear pressure directly affect the inner ear, causing sensorineural deafness as well as dizziness, vertigo, nausea, and vomiting. Head trauma and dramatic changes in atmospheric pressure are the most common causes. The usual treatment is restriction in activity (sometimes with complete bed rest), so that the fistula can heal. Surgical repair may be necessary, consisting of placement of a graft over the defect.
pilonidal fistula pilonidal sinus.
pulmonary arteriovenous fistula a congenital fistula between the pulmonary arterial and venous systems, allowing unoxygenated blood to enter the systemic circulation.
rectovaginal fistula one between the rectum and vagina.
rectovesical fistula one between the rectum and urinary bladder.
salivary fistula one between a salivary duct or gland and the cutaneous surface, or into the mouth through an abnormal pathway.
thoracic fistula one communicating with the thoracic cavity.
umbilical fistula one communicating with the intestine or urachus at the umbilicus.
urinary fistula any fistula communicating between the urinary tract and another organ or the surface of the body.
vesicoenteric fistula (vesicointestinal fistula) enterovesical fistula.
vesicovaginal fistula one from the bladder to the vagina.
arteriovenous
both arterial and venous; pertaining to both artery and vein.
arteriovenous anastomosis
a direct connection between an artery and a vein that acts as a shunt to bypass the capillary bed. These occur in areas where a high volume blood supply is needed only intermittently, e.g. the intestine.
arteriovenous fistula
an abnormal communication between an artery and a vein; includes cardiac defects such as ventricular septal defects and patent ductus arteriosus. Peripheral fistulae, especially in the extremities, may be localized, usually acquired and the result of trauma, while congenital defects tend to be more diffuse, involving a network of anastomosing vessels.
The effects of arteriovenous fistulae are variable, depending on their location and the amount of blood carried. Within the liver they usually connect the hepatic artery and portal vein, causing portal hypertension and ascites. Small peripheral fistulae may be noticeable only as warm, reducible swellings, often with an audible thrill, or give rise to edema distal to the site. More severe effects are also possible.
pulmonary arteriovenous fistula
a congenital anomalous communication between the pulmonary arterial and venous systems, allowing unoxygenated blood to enter the systemic circulation.
pulmonary arteriovenous fistula
Pulmonary arteriovenous malformation Pulmonology An abnormal arterioovenous communication in the lungs, resulting in right-to-left shunting of non oxygenated blood, a finding in1⁄3
of hereditary hemorrhagic telangiectasia, aka Osler-Weber-Rendu disease Clinical May be asymptomatic; Sx may include SOB, hemoptysis, cyanosis, finger clubbing, and a heart murmur heard by stethoscope over the malformation Management Unnecessary if
asymptomatic, or, surgical resection or embolization
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