Perianal fistula - complex with multiple ramifications

Case contributed by Pir Abdul Ahad Aziz Qureshi
Diagnosis certain

Presentation

Discharge from sinus opening at 4 o'clock in the perianal region.

Patient Data

Age: 40 years
Gender: Male

Scout showing O marker at the sinus opening at 4 o'clock position. The contrast was then given through feeding tube which outlines the complex linear tract with multiple ramifications some of which have also crossed midline. The tract communicates with the rectum.

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