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Perianal fistula (intersphincteric with intersphincteric abscess)

Case contributed by Mohammad A. ElBeialy
Diagnosis certain

Presentation

Perianal pain and discharge of pus.

Patient Data

Age: 45 years
Gender: Female

Left perianal intersphincteric fistulous tract is seen coursing between the internal and external anal sphincters with its anal mucosal opening at 5 O'clock position about 5 cm from the perianal skin.  An intersphincteric perianal horse-shoe marginally enhancing cystic lesion about 2.5 X 1.5 cm is seen with mild perianal inflammatory changes, the perianal abscess has two anal mucosal openings at 3 and 9 o’clock position.  

Intact pelvic floor muscles. Intact ischio-anal as well as ischio-rectal fossae on either side.  

Case Discussion

Grade II left perianal intersphincteric fistula tract with perianal abscess

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