Fistula -Medium 1-3 Biopsy cm
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Fistulas are commonly pathological and can result from: Infections, Inflammatory conditions (e.g., Crohn’s disease), Surgery or trauma, Malignancy or radiation damage
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🧪 What is a Fistula – Medium 1–3 cm Biopsy?
A fistula biopsy is a procedure where a sample of tissue is taken from a fistulous tract, usually during surgical exploration or treatment.
- A fistula is an abnormal connection between two epithelial surfaces — commonly involving skin, bowel, rectum, urinary tract, or vagina.
- A medium 1–3 cm biopsy indicates a moderate-sized specimen, typically large enough for histopathological evaluation, including inflammation, infection, or malignancy.
❓ Why is This Biopsy Done?
The biopsy is performed to:
- Diagnose the underlying cause of a chronic or recurrent fistula
- Rule out granulomatous infections (e.g., tuberculosis or Crohn’s disease)
- Check for malignant transformation, especially in long-standing fistulas
- Evaluate for foreign body reaction, radiation damage, or necrotizing infection
📊 Overview of the Procedure
- Tissue is typically collected during fistulectomy or fistulotomy
- The specimen is 1 to 3 cm in length
- Sent for histopathological examination and special stains if indicated
- Processing may include AFB staining, PCR for TB, and immunohistochemistry (IHC)
📈 Interpretation of Results
Histological Finding | Possible Interpretation |
|---|---|
Chronic granulation tissue, fibrosis | Non-specific chronic fistula |
Caseating granulomas | Suggests tuberculosis |
Non-caseating granulomas | Suggests Crohn’s disease |
Atypical squamous cells, carcinoma in situ | Suggests neoplastic change |
Foreign body giant cells | May indicate previous surgical material or chronic irritation |
🧠 Associated Organs and Conditions
Location | Possible Etiology |
|---|---|
Perianal / Anal | Cryptoglandular infection, Crohn’s disease, TB |
Enterocutaneous / Colocutaneous | Post-surgical, Crohn’s disease, malignancy |
Rectovaginal | Obstetric trauma, radiation, inflammatory bowel disease |
Vesicovaginal / Urethrocutaneous | Post-radiation, cancer, trauma |
Gastrointestinal Tract | Diverticulitis, ulcerative colitis, neoplasm |
🔄 Related / Follow-Up Tests
- AFB Stain / Ziehl-Neelsen stain – To detect tuberculosis
- PCR / CBNAAT (GeneXpert) – TB confirmation with rifampicin resistance
- Histopathology with H&E stain
- Immunohistochemistry (IHC) – For suspected malignancy
- Colonoscopy / Sigmoidoscopy – For Crohn’s or ulcerative colitis
- MRI Pelvis / Fistulogram – To map complex tracts
- Serum Inflammatory Markers (CRP, ESR)
✅ Fasting Required?
Parameter | Requirement |
|---|---|
Fasting Required | ❌ No fasting required for a routine fistula biopsy. |
📝 Summary
Parameter | Details |
|---|---|
What | Biopsy of a fistulous tract, typically 1–3 cm, for histopathological evaluation |
Why | To diagnose infection (TB, Crohn’s), check for malignancy, or assess chronic inflammation |
Size | Medium, approximately 1–3 cm |
Common Findings | Granulomas, chronic inflammation, fibrosis, possible neoplasia |
Associated Conditions | Tuberculosis, Crohn’s disease, malignancy, post-surgical complications |
Follow-up Tests | AFB stain, PCR, colonoscopy, IHC, MRI/fistulogram |
Fasting Required | No, unless performed under general anesthesia/sedation |
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