All Topics  
Fistula

 

 
   Email Print
   Bookmark   Link
 

 

Fistula
 
 
  Topics Fistula Topic Home

In medicine, a fistula (pl. fistulas or fistulae) is an abnormal connection or passageway between two epithelium
Epithelium

In biology and medicine, epithelium is a Biological tissue composed of cell s that line the cavities and surfaces of structures throughout the body....
-lined organs or vessels that normally do not connect.

ulas can develop in various parts of the body. The following list is sorted by the International Statistical Classification of Diseases and Related Health Problems
ICD

The International Statistical Classification of Diseases and Related Health Problems provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings,...
.









Causes
Various causes of fistula are:







Treatment
Treatment for fistulae varies depending on the cause and extent of the fistula, but often involves surgical intervention combined with antibiotic
Antibiotic

In common usage, an antibiotic is a substance or compound that kills or inhibits the growth of bacteria. Antibiotics belong to the group of antimicrobial compounds used to treat infections caused by microorganisms, including fungus and protozoa....
 therapy.

Typically the first step in treating a fistula is an examination by a doctor to determine the extent and "path" that the fistula takes through the tissue.

In some cases the fistula is temporarily covered, for example a fistula caused by cleft palate is often treated with a palatal obturator
Palatal obturator

A palatal obturator is a prosthesis that totally occludes an opening such as an oronasal fistula . They are similar to dental retainers, but without the front wire....
 to delay the need for surgery to a more appropriate age.

Surgery is often required to assure adequate drainage of the fistula (so that pus
Pus

Pus is a whitish-yellow, yellow or yellow-brown substance produced during inflammatory pyogenic bacteriuml infection. An accumulation of pus in an enclosed tissue space is known as an abscess....
 may escape without forming an abscess
Abscess

An abscess is a collection of pus that has accumulated in a cavity formed by the tissue on the basis of an infection process or other foreign materials ....
).






Discussion
Ask a question about 'Fistula'
Start a new discussion about 'Fistula'
Answer questions from other users
Full Discussion Forum



Encyclopedia


In medicine, a fistula (pl. fistulas or fistulae) is an abnormal connection or passageway between two epithelium
Epithelium

In biology and medicine, epithelium is a Biological tissue composed of cell s that line the cavities and surfaces of structures throughout the body....
-lined organs or vessels that normally do not connect.

Location of fistulas

Fistulas can develop in various parts of the body. The following list is sorted by the International Statistical Classification of Diseases and Related Health Problems
ICD

The International Statistical Classification of Diseases and Related Health Problems provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings,...
.

H: Diseases of the eye, adnexa, ear, and mastoid process

  • (H04.6) Lacrimal fistula
  • (H70.1) Mastoid fistula
    • Craniosinus fistula: between the intracranial space and a paranasal sinus
      Paranasal sinus

      Paranasal sinuses are air-filled spaces, communicating with the nasal cavity, within the bones of the skull and face....
  • (H83.1) Labyrinthine fistula
    • Perilymph fistula
      Perilymph fistula

      A labyrinthine fistula is leakage of inner ear fluid into the air filled middle ear.It is a cause of balance disorders and can be a complication of a stapedectomy....
      : tear between the membranes between the middle and inner ears
      EARS

      EARS may refer to:* Electoral software* Emirates Amateur Radio SocietySee also* Ears...
  • Preauricular fistula
    • Preauricular fistula: usually on the top of the cristae helicis ears
      EARS

      EARS may refer to:* Electoral software* Emirates Amateur Radio SocietySee also* Ears...


I: Diseases of the circulatory system

  • (I25.4) Coronary arteriovenous fistula, acquired
  • (I28.0) Arteriovenous fistula
    Arteriovenous fistula

    An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathology process, such as Physical trauma or erosion of an arterial aneurysm....
     of pulmonary vessels
    • Pulmonary arteriovenous fistula: between an artery and vein of the lungs, resulting in shunting
      Shunting

      Shunting is an event in the neuron which occurs when an excitatory postsynaptic potential and an inhibitory postsynaptic potential are occurring close to each other on a dendrite, or are both on the Soma of the cell....
       of blood
      Blood

      Blood is a specialized bodily fluid that delivers necessary substances to the body's Cell s ? such as nutrients and oxygen ? and transports waste products away from those same cells....
      . This results in improperly oxygenated blood.
  • (I67.1) Cerebral arteriovenous fistula
    Arteriovenous fistula

    An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathology process, such as Physical trauma or erosion of an arterial aneurysm....
    , acquired
  • (I77.0) Arteriovenous fistula
    Arteriovenous fistula

    An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathology process, such as Physical trauma or erosion of an arterial aneurysm....
    , acquired
  • (I77.2) Fistula of artery
    Artery

    Arteries are blood vessels that carry blood away from the heart. All arteries, with the exception of the pulmonary and umbilical arteries, carry oxygenated blood....


J: Diseases of the respiratory system

  • (J86.0) Pyothorax with fistula
  • (J95.0) Tracheoesophageal fistula
    Tracheoesophageal fistula

    A 'tracheoesophageal fistula' is an abnormal connection between the esophagus and the Vertebrate trachea. TEF is a common congenital abnormality, but when occurring late in life is usually the sequela of surgical procedures such as a laryngectomy....
     following tracheostomy: between the breathing and the feeding tubes


K: Diseases of the digestive system

  • (K11.4) Fistula of salivary gland
    Salivary gland

    The salivary glands in mammals are exocrine glands that produce saliva. They also secrete amylase, an enzyme that breaks down starch into glucose. In other organisms such as Insecta, salivary glands are often used to produce biologically important proteins like silk or glues, and fly salivary glands contain polytene chromosomes that have been usefu...
  • (K31.6) Fistula of stomach
    Stomach

    In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
     and duodenum
    Duodenum

    The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms anterior intestine or proximal intestine may be used instead of duodenum....
  • (K31.6) Gastrocolic fistula
  • (K31.6) Gastrojejunocolic fistula
    • Enterocutaneous fistula: between the intestine and the skin surface, namely from the duodenum
      Duodenum

      The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms anterior intestine or proximal intestine may be used instead of duodenum....
       or the jejunum
      Jejunum

      The jejunum is the middle section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms middle intestine or mid-gut may be used instead of jejunum....
       or the ileum
      Ileum

      The ileum is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine may be used instead of ileum....
      . This definition excludes the fistulas arising from the colon
      Colon (anatomy)

      The colon is the last portion of the digestive system in most vertebrates; it extracts water and salt from feces before they are defecation from the body....
       or the appendix
      Appendix

      Appendix, from the Latin word of the same name, may refer to an Index / Bibliography.* In book design, an appendix is a reference section at the end of a book ...
      .
    • Gastric fistula: from the stomach
      Stomach

      In most mammals, the stomach is a hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication....
       to the skin surface
  • (K38.3) Fistula of appendix
  • Anal fistula
    Anal fistula

    An anal fistula is an abnormal connection between the epithelialised surface of the anal canal and the perianal skin.Anal fistulae originate from the anal glands, which are located between the two layers of the anal sphincters and which drain into the anal canal....
    • Anorectal fistula: connecting the rectum
      Rectum

      The rectum is the final straight portion of the large intestine in some mammals, and the Gastrointestinal tract in others, terminating in the anus....
       or other anorectal
      Anorectal

      Anorectal anomalies are medical problems affecting the structure of the anus and rectum. A person with an anorectal anomaly would have some sort of deformative feature of the anus or rectum....
       area to the skin
      Skin

      The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
       surface. This results in abnormal discharge of feces
      Feces

      Feces, faeces, or f?ces is a waste product from an animal's gastrointestinal tract expelled through the anus during defecation....
       through an opening other than the anus
      Anus

      The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to expel feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest, such as coprolite ; food material after all the nutrients have b...
      . Also called fistula-in-ano.
      • Fecal fistula: see Anorectal
      • Fistula-in-ano
  • Anorectal fistula
  • (K63.2) Fistula of intestine
    Intestine

    In anatomy, the intestine is the segment of the Gastrointestinal tract extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine....
    • Enteroenteral fistula: between two parts of the intestine
      Intestine

      In anatomy, the intestine is the segment of the Gastrointestinal tract extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine....
  • (K82.3) Fistula of gallbladder
    Gallbladder

    The gallbladder is a small non-vital Organ which aids in the digestive process and concentrates bile produced in the liver....
  • (K83.3) Fistula of bile duct
    Bile duct

    A bile duct is any of a number of long tube-like structures that carry bile.Bile, required for the digestion of food, is excreted by the liver into passages that carry bile toward the hepatic duct, which joins with the cystic duct to form the common bile duct, which opens into the intestine....
    • Biliary fistula
      Biliary fistula

      A biliary fistula, a type of fistula where bile leaks from the bile ducts into outside areas, can occur as a complication following biliary Physical trauma, either iatrogenic or a result of a penetrating injury....
      : connecting the bile
      Bile

      Bile or gall is a bitter yellow or green fluid secreted by hepatocytes from the liver of most vertebrates. In many species, bile is stored in the gallbladder between meals and upon eating is discharged into the duodenum where the bile aids the process of digestion of lipids....
       ducts to the skin surface, often caused by gallbladder
      Gallbladder

      The gallbladder is a small non-vital Organ which aids in the digestive process and concentrates bile produced in the liver....
       surgery
    • Pancreatic fistula
      Pancreatic fistula

      A pancreatic fistula is an abnormal communication between the pancreas and other organs due to leakage of pancreatic secretions from damaged pancreatic ducts....
      : between the pancreas
      Pancreas

      The pancreas is a gland Organ in the digestive system and endocrine system of vertebrates. It is both an endocrine gland , as well as an exocrine gland, secreting pancreatic juice containing Digestion enzymes that pass to the small intestine....
       and the exterior via the abdominal wall


M: Diseases of the musculoskeletal system and connective tissue

  • (M25.1) Fistula of joint
    Joint

    A joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally....


N: Diseases of the genitourinary system

  • (N32.1) Vesicointestinal fistula
    Vesicointestinal fistula

    A vesicointestinal fistula is a form of fistula between the Urinary bladder and the bowel....
  • (N36.0) Urethral fistula
    • Innora:between the prostatic utricle
      Prostatic utricle

      The prostatic utricle is a small indentation located in the prostatic urethra, at the apex of the urethral crest, on the seminal colliculus, laterally flanked by openings of the ejaculatory ducts....
       and the outside of the body
  • (N64.0) Fistula of nipple
  • (N82) Fistulae involving female genital tract / Obstetric fistula
    Obstetric fistula

    Obstetric fistula is a severe medical condition in which a fistula develops between either the rectum and vagina or between the Urinary bladder and vagina after severe or failed childbirth, when adequate medical care is not available....
    • (N82.0) Vesicovaginal fistula
      Vesicovaginal fistula

      Vesicovaginal fistula is a subtype of female urogenital fistula ....
      : between the bladder
      Urinary bladder

      In anatomy, the urinary bladder is a solid, muscle, and distensible organ that sits on the pelvic floor in mammals. It is the organ that collects urine excreted by the kidneys prior to disposal by urination....
       and the vagina
      Vagina

      The vagina is a fibromuscular cylinder tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles....
    • (N82.1) Other female urinary-genital tract fistulae
      • Cervical fistula: abnormal opening in the cervix
        Cervix

        The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall....
    • (N82.2) Fistula of vagina to small intestine
      • Enterovaginal fistula: between the intestine
        Intestine

        In anatomy, the intestine is the segment of the Gastrointestinal tract extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine....
         and the vagina
        Vagina

        The vagina is a fibromuscular cylinder tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles....
    • (N82.3) Fistula of vagina to large intestine
      • Rectovaginal
        Rectovaginal fistula

        A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina. Rectovaginal fistula may be extremely debilitating....
        : between the rectum
        Rectum

        The rectum is the final straight portion of the large intestine in some mammals, and the Gastrointestinal tract in others, terminating in the anus....
         and the vagina
        Vagina

        The vagina is a fibromuscular cylinder tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles....
    • (N82.4) Other female intestinal-genital tract fistulae
    • (N82.5) Female genital tract-skin fistulae
    • (N82.8) Other female genital tract fistulae
    • (N82.9) Female genital tract fistula, unspecified


Q: Congenital malformations, deformations and chromosomal abnormalities

  • (Q18.0) Sinus
    Sinus (anatomy)

    Sinus is Latin for "bay", "pocket", "curve", or "bosom". In anatomy, the term is used in various contexts.A sinus is a sack or cavity in any organ or biological tissue, or an abnormal cavity or passage caused by the destruction of tissue....
    , fistula and cyst
    Cyst

    A cyst is a closed sac having a distinct biological membrane and cell division on the nearby Biological tissue. It may contain air, fluids, or semi-solid material....
     of branchial cleft
    • Congenital Preauricular fistula: A small pit in front of the ear
      Ear

      The ear is the sense organ that detects sounds. The vertebrate ear shows a common biology from fish to humans, with variations in structure according to order and species....
      . Also called Fistula Auris Congenita or Ear Pit.
  • (Q26.6) Portal vein-hepatic artery
    Hepatic artery

    Hepatic artery can refer to:* Common hepatic artery * Hepatic artery proper ...
     fistula
  • (Q38.0) Congenital fistula of lip
    Lip

    Lips are a visible body part at the mouth of humans and many animals. Lips are soft, movable, and serve as the opening for food intake, as an erogenous organ used in kissing and other acts of intimacy, as a tactile sensory organ, and in the articulation of speech....
  • (Q38.4) Congenital fistula of salivary gland
    Salivary gland

    The salivary glands in mammals are exocrine glands that produce saliva. They also secrete amylase, an enzyme that breaks down starch into glucose. In other organisms such as Insecta, salivary glands are often used to produce biologically important proteins like silk or glues, and fly salivary glands contain polytene chromosomes that have been usefu...
  • (Q42.0) Congenital absence, atresia
    Atresia

    Atresia is a condition in which a body orifice or passage in the body is abnormally closed or absent.Examples of atresia include:* Imperforate anus - malformation of the opening between the rectum and anus....
     and stenosis
    Stenosis

    A stenosis is an abnormal narrowing in a blood vessel or other tubular Organ or structure.It is also sometimes called a "stricture" .The term "coarctation" is synonymous, but is commonly used only in the context of aortic coarctation....
     of rectum
    Rectum

    The rectum is the final straight portion of the large intestine in some mammals, and the Gastrointestinal tract in others, terminating in the anus....
     with fistula
  • (Q42.2) Congenital absence, atresia
    Atresia

    Atresia is a condition in which a body orifice or passage in the body is abnormally closed or absent.Examples of atresia include:* Imperforate anus - malformation of the opening between the rectum and anus....
     and stenosis
    Stenosis

    A stenosis is an abnormal narrowing in a blood vessel or other tubular Organ or structure.It is also sometimes called a "stricture" .The term "coarctation" is synonymous, but is commonly used only in the context of aortic coarctation....
     of anus
    Anus

    The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to expel feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest, such as coprolite ; food material after all the nutrients have b...
     with fistula
  • (Q43.6) Congenital fistula of rectum
    Rectum

    The rectum is the final straight portion of the large intestine in some mammals, and the Gastrointestinal tract in others, terminating in the anus....
     and anus
    Anus

    The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to expel feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest, such as coprolite ; food material after all the nutrients have b...
  • (Q51.7) Congenital fistulae between uterus
    Uterus

    The uterus is a major female hormone-responsive reproductive sex organ of most mammals, including humans. It is within the uterus that the fetus develops during gestation....
     and digestive
    Digestive

    Digestive may refer to:*Digestion, biological process of metabolism*Digestive biscuit, a British semi-sweet biscuit*Digestif, small beverage at the end of a meal...
     and urinary tracts
  • (Q52.2) Congenital rectovaginal fistula
    Rectovaginal fistula

    A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina. Rectovaginal fistula may be extremely debilitating....


T: External causes

  • (T14.5) Traumatic arteriovenous fistula
  • (T81.8) Persistent postoperative fistula


Types of fistulas


Various types of fistulas include:

  • Blind: with only one open end
  • Complete: with both external and internal openings
  • Incomplete: a fistula with an external skin opening, which does not connect to any internal organ


Although most fistulas are in forms of a tube, some can also have multiple branches.

Causes


Various causes of fistula are:

  • Diseases: Inflammatory bowel diseases, such as Crohn's disease
    Crohn's disease

    Crohn's disease is an inflammatory disease which may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms....
     and ulcerative colitis
    Ulcerative colitis

    Ulcerative colitis is a form of inflammatory bowel disease . Ulcerative colitis is a form of colitis, a disease of the intestine, specifically the large intestine or colon , that includes characteristic Peptic ulcer, or open sores, in the colon....
    , are the leading causes of anorectal, enteroenteral, and enterocutaneous fistulas. A person with severe stage-3 hidradenitis suppurativa
    Hidradenitis suppurativa

    Hidradenitis suppurativa or HS is a skin disease that affects areas bearing apocrine sweat glands and hair follicles; such as the underarms, groin and buttocks....
     will also develop fistulas.


  • Medical treatment: Complications from gallbladder surgery can lead to biliary fistula. Radiation therapy can lead to vesicovaginal fistula. An arteriovenous fistula can be deliberately created, as described below in therapeutic use.


  • Trauma: Head trauma can lead to perilymph fistula
    Perilymph fistula

    A labyrinthine fistula is leakage of inner ear fluid into the air filled middle ear.It is a cause of balance disorders and can be a complication of a stapedectomy....
    s, whereas trauma to other parts of the body can cause arteriovenous fistulas. Obstructed labor can lead to vesicovaginal and rectovaginal fistulas. An obstetric fistula
    Obstetric fistula

    Obstetric fistula is a severe medical condition in which a fistula develops between either the rectum and vagina or between the Urinary bladder and vagina after severe or failed childbirth, when adequate medical care is not available....
     develops when blood supply to the tissues of the vagina and the bladder (and/or rectum) is cut off during prolonged obstructed labor. The tissues die and a hole forms through which urine and/or feces pass uncontrollably. Vesicovaginal
    Vesicovaginal fistula

    Vesicovaginal fistula is a subtype of female urogenital fistula ....
     and rectovaginal fistula
    Rectovaginal fistula

    A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina. Rectovaginal fistula may be extremely debilitating....
    s may also be caused by rape, in particular gang rape, and rape with foreign objects, as evidenced by the abnormally high number of women in conflict areas who have suffered fistulae. In 2003, thousands of women in eastern Congo presented themselves for treatment of traumatic fistula caused by systematic, violent gang rape that occurred during the country's five years of war. So many cases have been reported that the destruction of the vagina is considered a war injury and recorded by doctors as a crime of combat.


Treatment


Treatment for fistulae varies depending on the cause and extent of the fistula, but often involves surgical intervention combined with antibiotic
Antibiotic

In common usage, an antibiotic is a substance or compound that kills or inhibits the growth of bacteria. Antibiotics belong to the group of antimicrobial compounds used to treat infections caused by microorganisms, including fungus and protozoa....
 therapy.

Typically the first step in treating a fistula is an examination by a doctor to determine the extent and "path" that the fistula takes through the tissue.

In some cases the fistula is temporarily covered, for example a fistula caused by cleft palate is often treated with a palatal obturator
Palatal obturator

A palatal obturator is a prosthesis that totally occludes an opening such as an oronasal fistula . They are similar to dental retainers, but without the front wire....
 to delay the need for surgery to a more appropriate age.

Surgery is often required to assure adequate drainage of the fistula (so that pus
Pus

Pus is a whitish-yellow, yellow or yellow-brown substance produced during inflammatory pyogenic bacteriuml infection. An accumulation of pus in an enclosed tissue space is known as an abscess....
 may escape without forming an abscess
Abscess

An abscess is a collection of pus that has accumulated in a cavity formed by the tissue on the basis of an infection process or other foreign materials ....
). Various surgical procedures are commonly used, most commonly fistulotomy
Fistulotomy

A Fistulotomy is the surgical opening or removal of a Fistula tract. They can be performed by excision of the tract and surrounding tissue, simple division of the tract, or gradual division and assisted drainage of the tract by means of a seton; a cord passed through the tract in a loop which is slowly tightened over a period of days or...
, placement of a seton (a cord that is passed through the path of the fistula to keep it open for draining), or an endorectal flap procedure (where healthy tissue is pulled over the internal side of the fistula to keep feces or other material from reinfecting the channel). Treatments involving filling the fistula with fibrin glue or plugging it with plugs made of porcine small intestine submucosa have also been explored in recent years, with variable success. Surgery for anorectal fistulae is not without side effects, including recurrence, reinfection, and incontinence.

It is important to note that surgical treatment of a fistula without diagnosis or management of the underlying condition, if any, is not recommended. For example, surgical treatment of fistulae in Crohn's disease
Crohn's disease

Crohn's disease is an inflammatory disease which may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms....
 can be effective, but if the Crohn's disease itself is not treated, the rate of recurrence of fistula is very high (well above 50%).

Therapeutic use


In end stage renal failure patients, a cimino fistula
Cimino fistula

A Cimino fistula, also Cimino-Brescia fistula, surgically created arteriovenous fistula and arteriovenous fistula , is a type of vascular access for hemodialysis....
 is often deliberately created in the arm by means of a short day surgery in order to permit easier withdrawal of blood for hemodialysis
Hemodialysis

File:Plugged into dialysis.jpgIn medicine, hemodialysis is a method for removing waste products such as potassium and urea, as well as free water from the blood when the kidneys are in renal failure....
.

As a radical treatment for portal hypertension
Portal hypertension

In medicine, portal hypertension is hypertension in the portal vein and its tributaries.It is often defined as a portal pressure gradient of 5 mm Hg or greater....
, surgical creation of a portacaval fistula produces an anastomosis between the hepatic portal vein
Hepatic portal vein

The hepatic portal vein is a vein in the abdominal cavity that drains blood from the gastrointestinal tract and spleen. It is usually formed by the confluence of the superior mesenteric vein and splenic veins, and also receives blood from the inferior mesenteric vein, gastric vein, and cystic veins....
 and the inferior vena cava
Inferior vena cava

The inferior vena cava is the large vein that carries de-oxygenated blood from the lower half of the body into the right atrium of the heart....
 across the omental foramen (of Winslow). This spares the portal venous system from high pressure which can cause esophageal varices, caput madusae, and hemorrhoids.

External links



- supports the work of Dr Catherine Hamlin
Catherine Hamlin

E. Catherine Hamlin, Order of Australia is an Australian obstetrician and gynaecologist, the co-founder of Addis Ababa Fistula Hospital with her late husband Dr....
  AC
Order of Australia

The Order of Australia is an Order established by Elizabeth II of the United Kingdom, Monarchy of Australia on 14 February 1975 "for the purpose of according recognition to Australian citizens and other persons for achievement or for meritorious service"....
  at the Addis Ababa Fistula Hospital in Ethiopia. on fistulae in conflict areas in the Democratic Republic of the Congo , a Newsweek article on fistulae in conflict areas in the Democratic Republic of the Congo , IRIN, 16 November, 2005 , May 18, 2008