Question

32)    Fistula & Sinus
Complete the table below with respect to fistula and sinuses (30-50 words).

Type

32.1)     

Fistula hvea Sin- isu pare may bead

Description

Nursing considerations

Answer 1

A fistula is an abnormal pathway between two anatomic spaces or a pathway that leads from an internal cavity or organ to the surface of the body. A sinus tract is an abnormal channel that originates or ends in one opening. Sinus and fistula are 2 completely different things. They are not similar under any circumstances.

Fistulas are abnormal connections (anastomosis) between two surfaces, such as blood vessels, intestines, or other hollow organs. They are caused by injury or surgery, but they can also result from an infection, inflammation, or diseases such as Crohn's disease or ulcerative colitis. Left unrepaired, fistulas can be traumatic, debilitating, and can do additional harm to the body. Fistulas can develop in various parts of the body including: the eyes, adnexa, ear, the circulatory system (pulmonary vessels, arteries), the respiratory system (pyothorax, between the trachea and the esophagus), the digestive system (salivary gland, stomach, pancreas, anus, colon), between joints, and the urogenital system.

There are three types of fistulas: blind, or sinus tracts (with only one open end), complete (with both external and internal openings) and incomplete (with an external skin opening, which does not connect to any internal organ). Although most fistulas are in the form of a tube, some can also have multiple branches.

Sinus or sinus pressure points are the hollow cavities on the face, leg, hands, back at base of the skull, near the nose. These hollow cavities get filled with mucus when suffering from sinusitis. This causes pain, burning sensation, headache and other things. On the other hand, fistula is hollow connection between two body organs or hollow tubes. These connection either occur by injury or surgery. This something very fatal, as it causes inflammation of the tissues and abnormal growth of the body parts.

a Sinus : is “Abnormal” track connecting non epithelialized surface to another epithelialized surface .

a Fistula: is “Abnormal” track connecting two epithelialized surfaces.

Nasal sinuses :”Normal” air filled spaces found in the body.

There are five sinuses :Nasal.maxillary ,frontal,ethmoid and sphenoid sinuses.

Sinus is a blind ending tract, usually lined with granulation tissue that leads from an epithelial surface into the surrounding tissue, often into an abscess cavity. Fistula is an abnormal communication between the lumen of one viscus and the lumen of another viscus or the body surface.

The sinus are in the nasal area and a fistula is something that is a tube between two organs or just below the skin. One needs antihistamines and the other needs medical attention.

The most common causes of fistulas are:
Diseases: Inflammatory bowel disease in the form of Crohn's disease are the leading causes of anorectal, enteroenteral, and enterocutaneous fistulas. A person with severe stage-3 hidradenitis suppurativa may also develop fistulas.

Medical treatment: Complications from gallbladder surgery can lead to biliary fistula. Radiation therapy can lead to vesicovaginal fistula, however, may occur due to other causes, such as trauma.

Trauma: Head trauma can lead to perilymph fistulas, whereas trauma to other parts of the body can cause arteriovenous fistulas. Obstructed labor can lead to vesicovaginal and rectovaginal fistulas. An obstetric fistula develops when blood supply to the tissues of the vaginal 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.

A fistulogram uses a form of real-time x-ray called fluoroscopy and a barium-based contrast material to produce images of an abnormal passage within the body called a fistula. Similarly, a sinogram assesses an abnormal passage called a sinus that originates or ends in one opening, often on the skin. Both examinations are used to assess and diagnose the size and shape of fistulas and sinuses and any related abscess and/or infection.

A fistulogram is an x-ray procedure used to view a fistula, an abnormal passage between two or more anatomic spaces or organs or a pathway that leads from an internal cavity or organ to the surface of the body. A sinogram is a similar procedure done to assess a sinus, an abnormal passage or cavity that originates or ends in one opening, often on the skin. Contrast material is used to help identify the start of the fistula/sinus, its pathway and what organs are involved.

istulograms may also be used to assess abscess collections post-drainage and to determine whether there is a persistent communication from the collection to any surrounding structures.

Additionally, fistulograms are used to assess deliberately created fistulas in people receiving kidney dialysis. Repeated dialysis can cause scarring and damage to the vein, and veins exposed to arterial pressure and turbulent blood flow can become narrowed due to thickening of the blood vessel. A fistulogram is needed to assess the problem with the dialysis access. These procedures are known as Fistula/Graft Declotting and Interventions.

Sinuses can occur throughout the body and may be related to infection or injury. Symptoms may be mild, such as a discharge of clear fluid from the skin, or more serious, such as abscess formation. A sinogram can show the extent of the problem and help develop a plan for future care.