An anal fistula is an abnormal tract lined with granulation tissue that connects a main entrance inside the anal canal to a secondary opening on the perianal skin. Many people are unaware of the opening on the perianal skin since it is so small. An infection in the anal glands results in an accumulation of pus (abscess) in neighboring tissue, which leads to the development. Bacterial, fecal, or other debris can occasionally clog the anal gland, resulting in the formation of an abscess cavity. In many cases, an anal fistula is a single tube that links the inside of the anus/rectum to the skin around the anus. At times, the abscess may drain on its own, leaving a little passage behind. In rare cases, the problem is more complicated, with the abscess triggering the formation of "secondary tracts" or branching out if the abscess is trapped inside the tunnel, or with many tracts, potentially with multiple skin apertures.
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