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There is a transphincteric fistula arising from the lower anal canal near the dentate line at 12 o'clock anteriorly. The tract extends towards the right perinatal region into a fluid collection in the perinatal fat and also extends superiorly into the right ischioanal fossa. The collection measures 1.1cm transverse, 8.3cm craniocaudal and 1.5cm anteroposterior. The collection also demonstrates wall enhancement.
There is extensive inflammatory stranding surrounding the collection in the right ischioanal fossa and perirectal fat. The superior margin of the collection is at the level of the anorectal junction at the sacrococcygeal line. It extends inferiorly with an anterior ad posterior limb extending to the perinatal cleft region with the posterior limb opening at the skin in keeping with a fistula tract at 7 o'clock.
There are bilateral inguinal lymph nodes, the largest is on the right measuring 1.3cm X 1.4cm. The largest on the left measures 1.1cm X 0.7cm.
Acquired on a 1.5T Toshiba Titan.