Perianal fistula: with seton tube

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Painful anus with vaginal discharge due to a perianal fistula treated with insertion of a seton tube.

Patient Data

Age: 30 years
Gender: Female

Radiopaque seton tube passing from the anus to the fistula and out to the skin in a loop

Case Discussion

Seton tube placement involves passing a tube from the skin into the fistula entering the anal canal. Tube is then pulled through to the anal verge and joined to the skin end to form a loop.  It is left in situ for weeks to months to allow adequate drainage of the fistulous tract prior to fistulectomy. In some cases it is placed under tension (so-called "cutting seton") and periodically tightened such that it slowly pulls through to the outside via the sphincters allowing them to heal slowly behind the tube, reducing the risk of fecal incontinence.

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.