Perianal fistula (grade 4): transsphincteric

Case contributed by Dr Amro Omar


Perianal discharge

Patient Data

Age: 45
Gender: Female

A 6 o'clock transsphincteric perianal fistula is seen piercing both layers of the sphincter complex and takes a downward course through the ischiorectal and ischioanal fossae before reaching the perineal skin. Small abscess is seen in the tract, making it grade 4 (St James’s University Hospital Classification).

Case Discussion

Two working classifications of perianal fistulae: St James’s University Hospital Classification and Parks classification

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Case information

rID: 32671
Published: 27th Jan 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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