Fistula-in-ano

Anal fistula has long been notorious for its tendency to recur after operation and for the great difficulty in achieving a lasting cure while avoiding damage to the mechanism of anal continence. It was these unfavourable circumstances that led some surgeons to take a special interest in its management and were responsible for the establishment by Frederick Salmon in London 152 years ago of St. Mark’s Hospital, which at its inception appropriately bore the name “St. Mark’s Hospital for Fistula and other Diseases of the Rectum”. Anal fistula could thus be regarded as having played a key role in the creation of proctology as a special surgical discipline.