Perianal fistula - communicating with the vagina

Case contributed by Dr Ahmed Abdrabou


Recurrent offensive discharge from an opening around the anus

Patient Data

Age: 35 years old
Gender: Female

A perianal fistulous tract that arise at the right side at  7 o'clock of the anal canal. It penetrates the external anal sphincter at the midline posteriorly and divides into 2 branches at the intersphincteric level surrounding the anal canal. The right branch penetrates the posterior vaginal wall and communicates with the vaginal cavity while the left side branch ends in a collection. The vagina becomes filled with the injected contrast.

Annotated image

The red circle refers to the point of penetration of the right side fistula branch to the posterior vaginal wall

Case Discussion

Perianal fistula grade II intersphincteric type with associated small left side perianal abscess, penetration of posterior vaginal wall and communication with the vaginal cavity.

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Case information

rID: 37549
Published: 12th Jun 2015
Last edited: 1st Apr 2020
Inclusion in quiz mode: Included