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anorectal fistulaAn acutely inflamed “tract” which connects the anus and the rectum. Aetiology Trauma, abscesses, inflammatory processes (e.g., cancer), Crohn’s disease.
Clinical findings Chronic purulent discharge from a para-anal opening which, with a probe, leads to the rectum.
Management Small anal fistulas heal spontaneously; large ones require excision, which must follow 4 principles: find opening; find tract; unroof tract over its length; ensure that healing occurs from within outward.