Perianal fistula: trans-sphincteric
MRI perianal fistula
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Left sided trans-sphincteric active fistulous tract is seen, showing mucosal anal opening at 2 O'clock position, located 1 cm from the anal verge.
Course: Trans-sphincteric to the low ischioanal fat on the left. Cutaneous opening on the left side of the natal cleft. No side branches or abscesses.
Intact levator ani, with no supralevator collections identified.
MRI is the modality of choice to identify the type and course of perianal fistula. It differentiates active from chronic fistula as well as detection and localization of abcesses and side branches.
According to St James classifications, this fistula is considered grade 3 (trans-sphincteric).