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Perianal fistula with supralevator abscess

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

Liver cirrhosis. Purulent anal discharge.

Patient Data

Age: 65 years
Gender: Male

Two small trans-sphincteric fistulous tracts at about 9 o'clock leading into a large presacral abscess cavity with gas. Large volume of ascites due to liver cirrhosis.

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