What is a fistula?
A fistula is a non-natural, tubular connection between two cavities within the human body or on the body surface. The term “fistula” is derived from the Latin word “fistula”, which means “tube”. A fistula can occur as a result of a disease, in which case it is called “pathological” (abnormal).
In the course of surgical interventions, artificial connections can also be made, which are also called fistulas. A distinction is made between an inner and outer fistula. In an external fistula, a hollow organ is unnaturally connected to the body surface via a tubular opening.
An example of this is the so-called “enterocutaneous fistula”, in which, as the name suggests, the inside of the intestine has an additional exit to the skin. An internal fistula is the opening between two cavities within the body. An example of this is arteriovenous fistula, in which arterial and venous vessels are in contact via a tubular connection.
These are the causes
A distinction must be made between a congenital and an acquired fistula. During embryonic development, during which the organs are created, develop and take their final place in the body, malformations can occur. These can have serious consequences.
In some cases, two cavities are created from the originally identical organ formation. If they do not separate completely from each other, connections may remain as fistulas. An example of this is the oesophagotracheal fistula, in which the oesophagus and trachea have an opening left over from the embryonic period.
Fistulas can also result from injuries, for example during birth. The rectovaginal fistula, the so-called perineal tear, is an example of this. Some diseases, especially inflammation, can be the cause of fistulas.
In Crohn’s disease, for example, the inflammation of the bowel, which produces pus, sometimes results in a fistula. In everyday hospital life, artificially induced fistulas can also occur. These can be deliberately created during an operation, e.g. as an artificial bowel outlet, or they can occur unintentionally. In this case, a perforation can occur due to a mistake with invasive medical material. In the case of endoscopic operations, it is a possible complication.
