Perianal fistula grade 4 - transsphincteric

Case contributed by Amro Omar
Diagnosis certain

Presentation

Perianal discharge

Patient Data

Age: 45 years
Gender: Female
This study is a stack
Axial
STIR
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
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Info

A 6 o'clock transsphincteric perianal fistula is seen piercing both layers of the sphincter complex and takes a downward course through the ischiorectal and ischioanal fossae before reaching the perineal skin. Small abscess is seen in the tract, making it grade 4 (St James’s University Hospital Classification).

Case Discussion

Two working classifications of perianal fistulae: St James’s University Hospital Classification and Parks classification.

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