Perineal abscess

Case contributed by Dr Vinay Shah

Presentation

H/o operated case of hemorrhoid. C/o Pain and pus discharge at perineal region.

Patient Data

Age: 55 years
Gender: Male
MRI

Well-defined thick altered signal track is seen in the midline perineal region. After administration of contrast the track shows heterogeneous enhancement with nonenhancing internal components. The lesion causes slight right lateral displacement of the urethra and corpora spongiosa. The track measures approx 7.0 (AP) x 3.0 (TR) x 1.7 (SI) cm.

 The track is seen in the anterior perineal region. It is seen at periurethral region and base of penis. The lesion is seen adjacent to the corpora spongiosa and indentation the corpora cavernosa. Anteriorly the lesion is seen on the antero-inferior aspect of pubic symphysis upto the base of penis in midline perineum.

Posteriorly the lesion is extends in the midline ischio-anal fossa and into the intersphincteric region at 12 O’clock position. There is suspicious internal opening into the anal canal at 12 O’clock position. No obvious external opening is demonstrated.

 There is subtle marrow edema in the inferior pubic ramus on left side.

 

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Case Discussion

1.      Well-defined thick altered signal track in the midline perineal region with extension into the periurethral region, base of penis and into the intersphincteric region at 12 O’clock position. 1.      Subtle abnormal marrow signal in the inferior pubic ramous on left side, may represent marrow edema / early changes of osteitis. 

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Case information

rID: 20756
Case created: 10th Dec 2012
Last edited: 29th Jul 2017
System: Urogenital
Inclusion in quiz mode: Included

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