Pain around the anal region especially during defecation and sitting. Intermittent fever.
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There is a large collection which located in the bilateral ischioanal fossae and has one large track extending intersphincteric space at six o' clock forming the "horseshoe" pattern. Although the abscess reaches to levator base, it is not extending to the supralevator space, best seen on the sagittal images. The border of the collection and surrounding fatty tissue are contrast-enhancing because of inflammation.
Anorectal abscesses are an infective-inflammatory collection within the perianal region. They develop from infection and anal gland drainage obstruction and often associated with perianal fistulae. But our patient had no fistulae clinically.
- Ryan B. O???Malley, Mahmoud M. Al-Hawary, Ravi K. Kaza, Ashish P. Wasnik, Peter S. Liu, Hero K. Hussain. Rectal Imaging: Part 2, Perianal Fistula Evaluation on Pelvic MRI???What the Radiologist Needs to Know. (2012) American Journal of Roentgenology. 199 (1): W43-53. doi:10.2214/AJR.11.8361 - Pubmed