Presentation
Perianal discharge
Patient Data
Age: 45 years
Gender: Female
From the case:
Perianal fistula grade 4 - transsphincteric
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A 6 o'clock transsphincteric perianal fistula is seen piercing both layers of the sphincter complex and takes a downward course through the ischiorectal and ischioanal fossae before reaching the perineal skin. Small abscess is seen in the tract, making it grade 4 (St James’s University Hospital Classification).
Case Discussion
Two working classifications of perianal fistulae: St James’s University Hospital Classification and Parks classification.