Suprasphincteric anal fistula

Discussion:

As this track penetrates the low levator muscle, it is classified as a suprasphincteric track by the Parks classification, although if it penetrated the muscle just a couple of millimeters lower, it would be a high transsphincteric track, and in most instances, the differentiation between a high transsphincteric and suprasphincteric track is academic because the treatment would be the same. 

Another distinction is between suprasphincteric and extrasphincteric tracks - the former typically penerate the levator muscle above the sphincters and then the track heads inferiorly to an internal opening at the anorectal junction or within the anal canal, whereas with the latter the internal opening is within the rectum.

The St James University Hospital classification for this particular track would be grade 5 (supralevator or translevator extension).

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