Fish Bone in Fistula in Ano - Report of a Rare and Interesting Case

Abstract

Anal fistulas are a very common surgical problem that is seen in our day-to-day practice. Anal fistula is caused by idiopathic crypto-glandular infections in more than 90% of cases. The major complications include peritonitis, perforation and perianal abscesses and fistula. There are very few cases of anal fistula caused by an ingested foreign body reported in the literature. Here we report a rare case of a 35-year-old army man who had an anal fistula with impacted fish bone. The aim of this case report is to raise a suspicion of a foreign body in case of a chronic non healing perianal fistula and to avoid injury to surgeons’ fingers while exploring or performing a digital rectal examination. Perianal abscess and fistula are a cause of significant morbidity worldwide and have been documented since the time of Hippocrates (460 BC). Anorectal sepsis accounts for 0.5-1% of all surgical admissions and constitutes 20-25% of those for colorectal disorders.1 Except for unusual disease, fistula in ano originates from infection in the anal crypts of Morgagni, forming an abscess. The abscess, when it opens, result in a tract leading to the skin surface. This brief report presents a case of fistula-in-ano with unusual aetiology that is rarely reported in literature.