[SavageGlow]

Patient A is a 47-year-old female with no significant comorbidities who presented to the colorectal clinic due to concern for perianal fistula after colonoscopy by a referring provider. She was taken for a rectal examination under anesthesia for further evaluation and was found to have a trans-sphincteric fistula in the posterior midline involving greater than one-third of the sphincter complex. A seton was placed. Months later, she was brought for a rectal examination under anesthesia for further evaluation and definitive repair. The internal opening of the fistula was approximately 5 mm. A curvilinear incision was made in the posterior anal canal at the level of the intersphincteric groove and a dissection was made into the intersphincteric space, as shown in Figure 1. The fistula was identified in the intersphincteric space and dissected out, as shown in Figure 2. The fistula was then ligated. The defect was closed on both sides using 3-0 running and interrupted Vicryl sutures. Hydrogen peroxide was used and the repair was found to be intact. We then decided to use a 3 × 3 cm piece of ACell mesh in the intersphincteric space to provide coverage over the repair. The mesh was secured with 3-0 Vicryl sutures, as shown in Figure 3 and Figure 4. The incision was closed and the procedure was complete.

[Hogmann]

Nasty.

[William May]

I have a fistula. It's attached to my wristula.

[shadowstein]

I tried googling what a fistula was and I still don't understand.

[Hogmann]

Originally Posted by shadowstein ↗

I tried googling what a fistula was and I still don't understand.

It's an internal connection between two parts of your body that shouldn't be there.
In this case there was a connection between her vagina and rectum.

[Bletch]

[mintycbo]

Last few look like they were out of hellraiser...

[Guns N' Coffee]

No more fisting for her

[wmSgt]

I have one that the military had tried to repair 3 times. It happened after they fucked up stitching me up after the delivery of my son.