Anal Fistula - Fissure Complication

Subcutaneous perianal fistulas may occur either as a result of a chronic fissure-in-ano or as a variant of the fistula-in-ano formed from abscesses of the anal crypt glands. Sphincterotomy is mandatory in the fissure-fistula complex. Two cases are described which illustrate both etiologies. The differences in clinical presentation, pathology and treatment are discussed.