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Review
. 2021 Feb;49(2):300060520986669.
doi: 10.1177/0300060520986669.

Current concepts in the pathogenesis of cryptoglandular perianal fistula

Marcin Włodarczyk  1   2 , Jakub Włodarczyk  1   2 , Aleksandra Sobolewska-Włodarczyk  2   3 , Radzisław Trzciński  1 , Łukasz Dziki  1 , Jakub Fichna  2
Affiliations
Review

Current concepts in the pathogenesis of cryptoglandular perianal fistula

Marcin Włodarczyk et al. J Int Med Res. 2021 Feb.

Abstract

Cryptoglandular perianal fistula is a common benign anorectal disorder that is managed mainly with surgery. A fistula is typically defined as a pathological communication between two epithelialized surfaces. More specifically, perianal fistula manifests as an abnormal tract between the anorectal canal and the perianal skin. Perianal fistulas are often characterized by significantly decreased patient quality of life. The cryptoglandular theory of perianal fistulas suggests their development from the proctodeal glands, which originate from the intersphincteric plane and perforate the internal sphincter with their ducts. Involvement of proctodeal glands in the inflammatory process could play a primary role in the formation of cryptoglandular perianal fistula. The objective of this narrative review was to investigate the current knowledge of the pathogenesis of cryptoglandular perianal fistula with the specific aims of characterizing the potential role of proinflammatory factors responsible for the development of chronic inflammation. Further studies are crucial to improve the therapeutic management of cryptoglandular perianal fistulas.

Keywords: Cryptoglandular perianal fistula; adipokines; cytokines; pathogenesis; proctodeal glands; proinflammatory factors.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Factors involved in the healing of cryptoglandular perianal fistulas.
See this image and copyright information in PMC

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