Presentation
Perianal pain and swelling with discharge of pus and blood.
Patient Data
Age: 50 years
Gender: Male
From the case:
Peri-anal fistula: trans-sphincteric
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false},"extraPropsURL":"/studies/23616/annotated_viewer_json?lang=us"}
- a right perianal thick-walled trans-sphincteric fistulous tract about 9 cm long is seen with its opening of about 5 o'clock. The fistulous tract ascends upwards and then curved medially to pierce the the external and internal anal sphincters to open within the posterior wall of the anal canal.
- mild local peri-anal sepsis with enhancing inflammatory tissue is seen around the fistulous tract with local inflammatory changes of the right ischioanal and ischiorectal fossae.
- intact levator ani and pelvic floor muscles.
Case Discussion
Grade III right peri-anal trans-sphincteric fistulous tract with inflammatory changes of the right ischio-anal and ischiorectal fossae.