Perianal fistula: high trans-sphincteric

Case contributed by Dr Dalia Ibrahim


Pus discharge from the anus

Patient Data

Age: 30 years
Gender: Male

Hyperintense fistulous tract extends in the left ischioanal & ischiorectal  fossa for about 7 cm, it traverses the external anal sphincter opposite 3 O'clock arching over the puborectalis and below the levator ani muscle, to end in a horseshoe posterior intersphincteric collection measuring 3.0 cm, no side branches noted.


High trans-sphincteric fistula with horseshoe intersphincteric abscess.

Case Discussion

Controversy in the diagnosis of this case between "Suprasphincteric" & "High Trans-sphincteric" fistula,

It's usually difficult radiologically to differentiate suprasphincteric fistula from a high transsphincteric fistula. In any event, there is little difference in practical terms because surgical management is similar.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.