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Horseshoe fistula is one of the most. complex and potentially morbid. conditions faced in a modern anorectal. surgery. Hanley, 1965 reported his. original procedure for horseshoe fistula. which involved complete division of the. posterior 12 o'clock sphincter mechanism.
Overview. A fistula is an abnormal communication between 2 epithelialized surfaces, with an enterocutaneous fistula (ECF) being an abnormal communication between the small or large bowel and the skin.An ECF can arise from the duodenum, jejunum, ileum, colon, or rectum.(See the image below.).nteroatmospheric fistula (EAF), a special subset of ECF, is defined as a communication between the gastrointestinal (GI) tract and the atmosphere. It can occur as a complication of damage control laparotomy (DCL) and results in significant morbidity and mortality.