Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 3 complete abstracts (727 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
An abnormal anatomical passage between the intestine, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as stomach (gastrocolic fistula), the biliary tract (cholecystoduodenal fistula), or the urinary bladder of the urinary tract (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (medical errors).
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Fistula, Intestinal; Enterocutaneous Fistula; Fistula, Enterocutaneous; Cholecystoduodenal Fistula; Fistula, Cholecystoduodenal; Colovesical Fistula; Fistula, Colovesical.
Where it fits in the MeSH classification
- Broader topics
- Digestive System Fistula; Intestinal Diseases
- Narrower topics
- Rectal Fistula
Related concepts
- Intestines
- Stomach
- Biliary Tract
- Urinary Bladder
- Urinary Tract
- Medical Errors
Research landscape
PubMed indexes 17,598 records tagged with the MeSH heading “Intestinal Fistula” (counts retrieved 2026-11-04). 2,259 of them (12.8%) were published from 2020 onward, and the busiest period so far is through 1999 with 8,774 records.
Reviews account for 1,640 records (9.3%) and meta-analyses for 121. Randomized controlled trials number 227 (1.3%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 8,774 |
| 2000-2009 | 2,919 |
| 2010-2019 | 3,646 |
| 2020 onward | 2,259 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 1,640 | 9.3% |
| Meta-analyses | 121 | 0.7% |
| Randomized controlled trials | 227 | 1.3% |
Method: PubMed query "Intestinal Fistula"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in digestive system and liver
Gut and liver research ranges from laboratory studies of the microbiome to large trials of drugs and surgery. Symptoms such as pain, reflux or bowel change are reported by patients and overlap between conditions, and diet and microbiome studies are mostly observational. Check whether the study measured symptoms, tissue findings or long-term outcomes, how the diagnosis was made and how long people were followed. Nothing here replaces advice from a qualified clinician.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Spatial fibroblast niches define Crohn's fistulae | 2026 | Research article Design not recorded in structured metadata | 24 | cc by PMID 41224999 · DOI · PMC12804086 |
| Study on the factors influencing the prognosis after perianal abscess surgery | 2023 | Research article Design not recorded in structured metadata | 14 | cc by PMID 37759161 · DOI · PMC10537581 |
| Fistula development after anal abscess drainage-a multicentre retrospective cohort study | 2023 | Research article Design not recorded in structured metadata | 13 | cc by PMID 38093036 · DOI · PMC10719138 |
Spatial fibroblast niches define Crohn's fistulae [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Crohn's disease often presents with fistulae, abnormal tunnels that connect the intestine to the skin or other organs.
- Closing excerpt
- This resource will inform the development of model systems and interventions to mitigate aberrant fibroblast activity while preserving their regenerative properties in Crohn's disease.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (229 words)
Crohn's disease often presents with fistulae, abnormal tunnels that connect the intestine to the skin or other organs. Despite their profound effect on morbidity, the molecular basis of fistula formation remains unclear, largely owing to the challenge of capturing intact fistula tracts and their inherent heterogeneity1-3. Here we construct a subcellular-resolution spatial atlas of 68 intestinal fistulae spanning diverse anatomical locations. We describe fistula-associated epithelial, immune and stromal cell states, revealing abnormal zonation of growth factors and morphogens linked to establishment of tunnelling anatomy. We identify fistula-associated stromal (FAS) fibroblasts, which are assembled in concentric layers: a proliferative, lumen-adjacent zone beneath neutrophil and macrophage-rich granulation tissue, an active lesion core of FAS cells and a quiescent, pro-fibrotic outer zone. We examine the architecture of the extracellular matrix in the fistula tract and demonstrate that FAS populations associate with distinct collagen structures, exhibiting properties ranging from proliferation, migration and extracellular matrix remodelling to dense collagen deposition and fibrosis. We define niches supporting epithelialization of fistula tunnels and a FAS-like population that is detected at the base of ulcers in non-penetrating Crohn's disease. Our study demonstrates that common molecular pathways and cellular niches underpin fistulae across intestinal locations, revealing the cellular protagonists of fistula establishment and persistence. This resource will inform the development of model systems and interventions to mitigate aberrant fibroblast activity while preserving their regenerative properties in Crohn's disease.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41224999 · DOI · PMC12804086
Study on the factors influencing the prognosis after perianal abscess surgery [2]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectiveTo study the influence of clinical characteristics and diagnosis and treatment methods of perianal abscess on postoperative recurrence or formation of anal fistula to provide a basis for selecting appropriate surgical and inspection methods for clinical treatment of perianal abscess in the future.
- Closing excerpt
- ConclusionPreoperative assessment of the abscess range and precise intraoperative methods to resolve the infection of the abscess glands in the internal mouth can effectively improve the cure rate.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (280 words)
ObjectiveTo study the influence of clinical characteristics and diagnosis and treatment methods of perianal abscess on postoperative recurrence or formation of anal fistula to provide a basis for selecting appropriate surgical and inspection methods for clinical treatment of perianal abscess in the future.MethodsThe clinical data of 394 patients with perianal abscesses were collected, the influencing factors were investigated, and univariate analysis and multivariate logistic regression analysis were performed to further determine the risk factors affecting the prognosis of perianal abscess.ResultsThe results showed that the rate of preoperative blood routine results in the uncured group was higher (51.16%) than in the cured group (35.61%); the rate of high abscess space in the uncured group (23.26%) was higher than in the cured group (9.11%); the proportion of patients in the uncured group who underwent magnetic resonance imaging (MRI) before surgery (27.90%) was lower than in the cured group (45.30%); the proportion of patients in the uncured group who underwent simple drainage (51.16%) was higher than in the cured group (28.49%). The two groups had significant differences in perineal MRI examination, surgical method, preoperative blood routine, and abscess space (p = 0.030, p = 0.002, p = 0.047 and p = 0.010, respectively). Based on the results of univariate analysis and multivariate logistic regression analysis, the extent of the abscess cavity (OR = 2.544, 95%CI = 1.087-5.954, p = 0.031) and the surgical method (OR = 2.180, 95%CI = 1.091-4.357, p = 0.027) were independent influencing factors for postoperative recurrence of perianal abscess or anal fistula.ConclusionPreoperative assessment of the abscess range and precise intraoperative methods to resolve the infection of the abscess glands in the internal mouth can effectively improve the cure rate.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37759161 · DOI · PMC10537581
Fistula development after anal abscess drainage-a multicentre retrospective cohort study [3]
Abstract reading summary — source excerpts
- Opening excerpt
- PurposeAnal abscesses are common and, despite correct treatment with surgical drainage, carry the risk of developing fistulas.
- Closing excerpt
- These findings are clinically relevant and could influence the selection of patients for specialised follow-up, facilitate expedited diagnosis, and potentially prevent unnecessarily long treatment courses.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (218 words)
PurposeAnal abscesses are common and, despite correct treatment with surgical drainage, carry the risk of developing fistulas. Studies identifying risk factors for the development of anal fistulas are sparse. This study aimed to identify the risk factors for anal fistulas after anal abscess surgery.MethodsThis was a multicentre, retrospective cohort study of patients undergoing acute surgery for anal abscesses in the Capital Region of Denmark between 2018 and 2019. The patients were identified using ICD-10 codes for anal abscesses. Predefined clinicopathological factors and postoperative courses were extracted from patient records.ResultsA total of 475 patients were included. At a median follow-up time of 1108 days (IQR 946-1320 days) following surgery, 164 (33.7%) patients were diagnosed with an anal fistula. Risk factors for developing fistulas were low intersphincteric (OR 2.77, 95CI 1.50-5.06) and ischioanal (OR 2.48, 95CI 1.36-4.47) abscesses, Crohn's disease (OR 5.96, 95CI 2.33-17.2), a history of recurrent anal abscesses (OR 4.14, 95CI 2.47-7.01) or repeat surgery (OR 5.96, 95CI 2.33-17.2), E. coli-positive pus cultures (OR 4.06, 1.56-11.4) or preoperative C-reactive protein (CRP) of more than 100 mg/L (OR 3.21, 95CI 1.57-6.71).ConclusionSeveral significant clinical risk factors were associated with fistula development following anal abscess surgery. These findings are clinically relevant and could influence the selection of patients for specialised follow-up, facilitate expedited diagnosis, and potentially prevent unnecessarily long treatment courses.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 38093036 · DOI · PMC10719138
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article ACG Clinical Guideline: Management of Crohn's Disease in Adults [4]
- Research article ECCO Guidelines on Therapeutics in Crohn's Disease: Medical Treatment [5]
- Research article AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease [6]
- Research article Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula [7]
- Research article Systematic review and meta-analysis of the open abdomen and temporary abdominal closure techniques in non-trauma patients [8]
- Research article Estimating the prevalence of obstetric fistula: a systematic review and meta-analysis [9]
References
- McGregor C, Qin X, Jagielowicz M, Gupta T, Yin Z, Lentsch V, et al.. Spatial fibroblast niches define Crohn's fistulae. . 2026. PMID 41224999 · DOI · PMC12804086
- Dong S, Chen B, Zhang J. Study on the factors influencing the prognosis after perianal abscess surgery. . 2023. PMID 37759161 · DOI · PMC10537581
- Skovgaards DM, Perregaard H, Dibbern CB, Nordholm-Carstensen A. Fistula development after anal abscess drainage-a multicentre retrospective cohort study. . 2023. PMID 38093036 · DOI · PMC10719138
- Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE. ACG Clinical Guideline: Management of Crohn's Disease in Adults. Am J Gastroenterol. 2018. PMID 29610508 · DOI
- Torres J, Bonovas S, Doherty G, Kucharzik T, Gisbert JP, Raine T, et al.. ECCO Guidelines on Therapeutics in Crohn's Disease: Medical Treatment. J Crohns Colitis. 2020. PMID 31711158 · DOI
- Feuerstein JD, Ho EY, Shmidt E, Singh H, Falck-Ytter Y, Sultan S, et al.. AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease. Gastroenterology. 2021. PMID 34051983 · DOI · PMC8988893
- Vogel JD, Johnson EK, Morris AM, Paquette IM, Saclarides TJ, Feingold DL, et al.. Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula. Dis Colon Rectum. 2016. PMID 27824697 · DOI
- Atema JJ, Gans SL, Boermeester MA. Systematic review and meta-analysis of the open abdomen and temporary abdominal closure techniques in non-trauma patients. World J Surg. 2015. PMID 25446477 · DOI
- Adler AJ, Ronsmans C, Calvert C, Filippi V. Estimating the prevalence of obstetric fistula: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013. PMID 24373152 · DOI · PMC3937166
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.