Binding of Isaac: Rebirth Wiki

Fistula is a boss that can appear:

The large Fistula has 60 HP, the medium forms have 15 HP, and the small forms have 8 HP.

Behavior[ | ]

  • Moves around the room slowly, bouncing off the walls.
  • When enough health is depleted, the one large Fistula breaks into four medium Fistulas.
    • Medium forms behave identically but move slightly faster and can bounce off other enemies.
  • Each of the four medium Fistulas breaks into two small Fistulas.
    • Small forms behave identically but move very fast.
  • Each of the smallest Fistulas spawns a ChargerCharger with 15 health points on defeat unless they are over a pit or other obstacle.
  • Altogether, the pieces have a combined total of 184 HP (304 HP if including the 8 Chargers).
  • All stages of Fistula deal a whole heart of contact damage.

Champion Versions Needs to be unlocked[ | ]

Grey: 15% larger with 25% more HP (75). Spawns Boom FlyBoom Flies with 15 health points instead of Chargers unless the smallest Fistula piece is over a pit or other obstacle. Each piece travels much slower and splits into three medium Fistulas as opposed to the original's four, similar to Boss Teratoma ingameTeratoma.

Gallery[ | ]

Trivia[ | ]

  • Fistula appeared in the original The Binding of Isaac.
  • A fistula is an abnormal connection between organs, intestines, and other tissues.
  • Fistula’s splittings after taking enough damage is a reference to the game Asteroids, where asteroids would float diagonally and split after taking enough damage. This was confirmed by Edmund McMillen[citation needed].
  • (except in Repentance) Fistula used to be a CavesCaves / CatacombsCatacombs boss in the original The Binding of Isaac, but as of Rebirth, it was a CellarCellar boss.
    • (in Repentance) It has been moved back into the Caves.
  • Teratoma is the posthumous version of Fistula.
  • Unlike the original The Binding of Isaac, Fistula doesn't bounce off of rocks.
  • Fistula was inspired by a boss of the same name in another Edmund McMillen game, C-Word.
  • (in Afterbirth † and Repentance) FistuloidFistuloid is an enemy variant of this boss combined with what looks to be a Charger or SpittySpitty.
  • (in Afterbirth † and Repentance) Boss The Matriarch ingameThe Matriarch is a boss added in Booster Pack #5 that is simultaneously based of a Fistuloid, Boss Chub ingameChub, and this boss. The Matriarch will also spawn small Fistulas throughout the battle.
  • (in Repentance) Boss Mother secondphase ingameMother will spawn a unique Fistula with a rotten appearance during one of her attacks.
    • A similar Looking Fistula can be encountered in the CorpseCorpse.
  • (in Repentance) Fistula is one of four bosses that can be spawned by Boss It Lives ingameIt Lives, the other three being Chub, Boss Polycephalus ingamePolycephalus and Teratoma.