Perianal fistula - inter-sphincteric type

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Purulent perianal discharge.

Patient Data

Age: 35 years
Gender: Male

A 25 mm thin-walled tract starts at the left perianal region and courses upwards between the internal and external anal sphincters to open into the anal canal at the 12 o’clock orientation.

There is a 10 mm oval-shaped abnormal signal (low on T1 and high on T2fs) intraosseous lesion along the left femur intertrochanteric region.

Case Discussion

MRI imaging findings are consistent with a grade I low-type intersphincteric perianal fistula without evidence of the perianal abscess.

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