Presentation
Swelling, pain, and itching around the perianal area.
Patient Data
The fistula tract measures approximately 1.2 cm, originating from the left perianal area and extending upward between the internal and external anal sphincters, opening into the anal canal at the 12 o'clock position. The internal opening of the fistula is located about 8 mm from the anal verge. The fistula shows strong enhancement after contrast injection, with an associated fluid collection (abscess) at the left perianal margin. The fluid shows restricted diffusion and peripheral enhancement.
Case Discussion
The MRI findings and clinical examination are consistent with an intersphincteric perianal fistula (according to Park’s classification) with an abscess at the anal margin, and an active tract with strong contrast enhancement.
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