Elderly patient presented with pain and perianal pustule.
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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.
An anorectal abscess arises from the epithelium of anal canal, from there infection can spread to intersphincteric space, ischiorectal fossa and supralevator space.