Peri-anal fistula: trans-sphincteric

Case contributed by Dr Mohammad A. ElBeialy


Perianal pain and swelling with discharge of pus and blood.

Patient Data

Age: 50 years
Gender: Male
  • a right perianal thick-walled trans-sphincteric fistulous tract about 9 cm long is seen with its opening of about 5 o'clock. The fistulous tract ascends upwards and then curved medially to pierce the the external and internal anal sphincters to open within the posterior wall of the anal canal.
  • mild local peri-anal sepsis with enhancing inflammatory tissue is seen around the fistulous tract with local inflammatory changes of the right ischioanal and ischiorectal fossae.
  • intact levator ani and  pelvic floor muscles.  

Case Discussion

Grade III right peri-anal trans-sphincteric fistulous tract with inflammatory changes of the right ischio-anal and ischiorectal fossae.

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Case information

rID: 23520
Published: 20th Jun 2013
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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