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 (pulmonary arteriovenous fistula)
- 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)
Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006.
Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 17th ed. Philadelphia, Pa: Saunders Elsevier; 2006.
Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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