Presentation
Recurrent offensive discharge from an opening around the anus
Patient Data
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A perianal fistulous tract that arise at the right side at 7 o'clock of the anal canal. It penetrates the external anal sphincter at the midline posteriorly and divides into 2 branches at the intersphincteric level surrounding the anal canal. The right branch penetrates the posterior vaginal wall and communicates with the vaginal cavity while the left side branch ends in a collection. The vagina becomes filled with the injected contrast.
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The red circle refers to the point of penetration of the right side fistula branch to the posterior vaginal wall
Case Discussion
Perianal fistula grade II intersphincteric type with associated small left side perianal abscess, penetration of posterior vaginal wall and communication with the vaginal cavity.