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an anal fistula is an inflammatory tract between the anal canal and the skin. The 4 categories of fistulas, based on the relationship of fistula to sphincter muscles, are intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric. An anal fistula can be categorized as either simple or complex. Anal fistula is a chronic abnormal communication between the epithelialised surface of the anal canal and usually the perianal skin. An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. Anal fistulae commonly occur in people with a history of anal abscesses. Anal abscesses are the acute manifestation of a purulent infection in the perirectal area, while anal fistulas are the chronic manifestation of such infections. An anal abscess is a pus-filled cavity that most commonly develops from an infected anal crypt gland following obstruction and bacterial overgrowth. a fistula is an abnormal connection between two epithelialized surfaces, and is lined with granulation tissue. A perineal fistula is one between the intestine and the perineal skin (anal fistula) or between the intestine and the vagina (a colovaginal fistula). Anal fistulae affect 1 in 10,000 of the normal population every year. An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on toilet paper and undergarments, or sometimes in the toilet. If acute they are painful after defecation, but with chronic fissures, pain intensity often reduces. Anal fissures usually extend from the anal opening and are usually located posteriorly in the midline. Please use one of the following formats to cite this article in your essay, paper or report apa. There are various different types of surgery for anal fistula see the what happens during surgery section below for full details. All types of surgery for anal fistula aim to get rid of the fistula, while causing as little damage to the sphincter muscles around your anus as possible.