Perianal fistula

Case contributed by Sameh Saied Ali
Diagnosis certain

Presentation

Persistent anal pain with intermittent bleeding and discharge

Patient Data

Age: 40 years
Gender: Male
mri
  • linear fistulous tract is seen oriented vertically, passing through the left side of the inter-sphincteric plane, starting superiorly from the level of the dentate line where it is seen abutting the internal sphincter at 1-2 o'clock position, and extending inferiorly to open into a marginally enhancing inflammatory fluid collection (abscess)
  • the external sphincter is intact
  • no definite side branches

Case Discussion

Surgically proved low type inter-sphincteric fistula. 

The integrity of the external anal sphincter is crucial for the management's planning, also it is important to identify any side branches. 

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