1. Sinus and Fistula by Dr. Nimer Khraim (BVMS.DVMS.MVSc.PhD(Dr.med.vet)

2. Sinus and Fistula  Sinus: a blind purulent tract showing no tendency to heal  Fistula: Abnormal opening between cavity or duct ( like fistula wethers in horses and recto-vaginal fistula

3. Purulent fistula or sinus

4. Sinus and Fistula Etiology  Drainage from purulent cavity (guttural pouch) in horse  Presence of F.B or necrotic T.  Specific lesion may lead to fistula formation in the T. (carcinoma, mycosis, T.B)

5. Sinus and Fistula Clinical signs  The orifice of the fistula or the sinus may be very narrow and only permit admitting of probe

6. Sinus and Fistula  It may be surrounded by excessive granulation T. when its recent  or may be hard or fibrous when its old (due to fibrosis in surrounding T.)

7. Sinus and Fistula  There may be more than one opening leading to the center of the lesion  A sinus may close for a variable time until a new abscess form and burst

8. Sinus and Fistula Treatment  Provide drainage  Used of liquid or solid caustics  Operation to the appear sinus  Penicillin injection