الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Anal fistula is a highly typical perianal disease that causes the patient a great deal of discomfort and morbidity. It is described as a granulation tissue-lined hollow tract that connects a primary opening deep within the anal canal to a secondary entrance superficially located beneath the perianal epidermis, It is typically nonspecific (idiopathic, cryptoglandular), with infection of an anal gland in the intersphincteric space as the initiating pathology.
However, it could be associated with a variety of specific conditions, including Crohn’s disease, tuberculosis, malignancy, perianal trauma, and foreign bodies.
Anal abscess formation is a persistent symptom of an acute perirectal process. An epithelialized track may grow to connect the abscess in the anus or rectum with the superficial perirectal skin when the abscess ruptures or is surgically drained, between 26% and 38% of anal abscesses result in an anal fistula.
According to research. The median age at presentation is 40 years old, with a range of 20 to 60 years. Males are more likely than females to acquire an anal fistula.
Prior to the intervention, a thorough clinical and radiological assessment is needed to identify the tracts in high anal fistula. The diagnosis is generally based on distinctive signs, such as a perirectal skin lesion, pain, and purulent drainage, in the patient’s medical history and on physical examination. Endo-anal ultrasound and magnetic resonance imaging (MRI) aid in diagnosing and aid in identifying the tracts. While the perineal and digital rectal examinations will allow the anal sphincter structure and tone to be examined before surgery, the patients typically