Intersphincteric anal fistula

Case contributed by Ali Abougazia
Diagnosis almost certain

Presentation

Known case of perianal fistula, preoperative planning.

Patient Data

Age: 55 years
Gender: Male
mri

A 3 cm thick-walled tract starts at the left perianal region and courses upwards between internal and external anal sphincters to open into the anal canal at 6 o’clock orientation.

Incidental right-sided fat-containing indirect inguinal hernia.

Annotated image

The fistulous track is marked by arrows in these images.

Case Discussion

Left sided inter-sphincteric perianal fistula as described.

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