In medicine, a fistula (/ˈfɪstjʊlə/;[1][2] pl. fistulas /ˈfɪstjʊləz/, or fistulae (/ˈfɪstjʊli/ or /ˈfɪstjʊlaɪ/)) is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect.[3] It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons.
In end stage renal failure patients, a cimino fistula is often deliberately created in the arm by means of a short day surgery in order to permit easier withdrawal of blood for hemodialysis.
As a radical treatment for portal hypertension, surgical creation of a portacaval fistula produces an anastomosis between the hepatic portal vein and the inferior vena cava across the omental foramen (of Winslow). This spares the portal venous system from high pressure which can cause esophageal varices, caput medusae, and hemorrhoids.
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