Sinus-Fistula: Examination

                                                                Sinus-Fistula: Examination

[A] Inspection

1.       „Site of fistula

2.       „Number of external openings: Single or multiple

3.       „ Appearance of external opening

·         Any presence of granulation tissue

·         Margin of the opening

4.       „ Discharge from the opening:

·         Character

·         Odour

5.       „Area adjacent to the external opening:

·         swelling

·         scar

·         pigmentation

[B] Palpation

·         „ Temperature/ tenderness around external opening

·         „ Wall of the tract: thickened or not

·         „ any swelling adjacent to the sinus/fistula

·         „ any bone thickening adjacent to the external opening (osteomyelitis)

·         „ DRE (perianal fistula) -to assess the presence of internal opening

·         „ PV examination- in vesicovaginal or rectovaginal fistula

[C] Examination of Regional Lymph Nodes