MAMMARY FISTULA

Definition

Mammary fistula is an abnormal tract or passage connecting the skin to the breast tissue, often resulting from chronic infection or abscess.

Types

There are two types of mammary fistula:

1. Congenital fistula: Present at birth, often associated with other congenital anomalies.
2. Acquired fistula: Develops later in life due to chronic infection, trauma, or surgery.

Pathology

Mammary fistula is characterized by the formation of a tract or passage between the skin and the breast tissue, which can lead to persistent discharge, pain, and infection.

Causes

Mammary fistula can be caused by:

1. Chronic infection or abscess: Bacterial or fungal infections that lead to abscess formation and subsequent fistula development.
2. Trauma: Physical injury to the breast tissue, leading to fistula formation.
3. Surgery: Complications from breast surgery, such as mastectomy or breast biopsy.
4. Tumors: Malignant or benign tumors that erode into the skin and cause fistula formation.

Clinical Features

Mammary fistula presents with:

1. Discharging sinus: A persistent opening in the skin that discharges pus or fluid.
2. Pain: Pain or tenderness in the affected area.
3. Infection: Redness, swelling, and warmth around the fistula.
4. Discharge: Thick, yellow or greenish discharge from the fistula.

Investigations

Diagnosis is often made based on clinical examination and history. However, imaging studies such as:

1. Mammography: To evaluate the breast tissue and identify any underlying abnormalities.
2. Ultrasound: To evaluate the tissue around the fistula and identify any abscesses or tumors.
3. Biopsy: To confirm the presence of infection, tumor, or other underlying conditions.

Complications

Mammary fistula can lead to:

1. Infection: Spread of infection to surrounding tissues and organs.
2. Abscess formation: Development of abscesses in the surrounding tissue.
3. Scarring: Formation of scar tissue around the fistula, leading to chronic pain and discomfort.

Management

Management of mammary fistula involves:

1. Antibiotics: Treatment of underlying infection with antibiotics.
2. Drainage: Draining the abscess or fistula to prevent further infection.
3. Surgery: Surgical excision of the fistula and surrounding tissue to prevent recurrence.
4. Wound care: Proper wound care and dressing to promote healing and prevent infection.

Treatment

Treatment of mammary fistula depends on the underlying cause and may involve:

1. Surgery: Excision of the fistula and surrounding tissue.
2. Drainage: Draining the abscess or fistula to prevent further infection.
3. Antibiotics: Treatment of underlying infection with antibiotics.
4. Wound care: Proper wound care and dressing to promote healing and prevent infection.

Homeopathic Therapeutic Medicines

The following homeopathic medicines may be used to treat mammary fistula:

1. Belladonna: For acute inflammation and pain.
2. Calcarea carbonica: For chronic infection and abscess formation.
3. Silica: For chronic fistula formation and scar tissue.
4. Graphites: For chronic wounds and ulcers.
5. Thuja: For chronic infections and abscesses.