Presentation
Elderly patient presented with pain and perianal pustule.
Patient Data
Extensive loculated fluid collection encircling the rectosigmoid and anal canal with surrounding inflammation suggestive of an anorectal abscess.
The abscess is extending from supralevator regions bilaterally to intersphincteric region. A complex fistulous tract is advancing from the left intersphincteric abscess to the subcutaneous region on the left side at 4-5 o'clock position in relation to the anal opening, less than 5 mm from the skin surface suggestive of an impending fistula.
The abscess is causing significant rectal and anal luminal compromise.
Case Discussion
An anorectal abscess arises from the epithelium of anal canal, from there infection can spread to intersphincteric space, ischiorectal fossa and supralevator space.
This is a case of an extensive perianal abscess with impending fistula formation and supralevator and intersphincteric extension with involvement of the left ischiorectal fossa.
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