Presentation
An orifice on the skin around the anus at 7 o'clock is about 3 cm from the anus. Oozing of pus, blood and stool from the tunnel opening.
Patient Data
By injecting contrast material from the orifice at about 7 o'clock and at a distance of 3 cm from the anus (patient in the prone position), a tract with approximately 8 cm length is visible, and there is evidence of contrast entering the distal of the rectum.
Case Discussion
This case demonstrates a perianal fistula with fistulography.
Fistulography is a traditional radiological technique used to define the anatomy of perianal fistulas. In fistulography, the external opening is catheterized with a fine cannula, and a water-soluble contrast agent is injected to determine the fistulous tract.
MRI is the imaging modality of choice for evaluating the perianal fistula. When MRI is contraindicated, fistulography could be performed, although unreliable and difficult to interpret.
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