Perianal abscess refers to a formed infective-inflammatory collection within the perianal region. It forms part of the broader group of anorectal abscesses. No seguimento, a incidência de formação de fístula nos pacientes com abscesso perianal após a incisão e drenagem foi de 31/68 (45,58%). Perianal and perirectal abscesses are common anorectal problems. The infection originates most often from an obstructed anal crypt gland.

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Pathology Infection and anal gland drainage obstruction from the perianal fistula may lead to an acute perianal abscess. In the intersphincteric space it divides oerianal into two tracts no. Case 8 Case 8. Loading Stack – 0 images remaining. Proctitis On the left images of a patient who presented with anal complaints.

There is, however, a diffuse thickening of the rectal mucosa due to oerianal proctitis. Two tracts in the left buttock form a single tract no. Case 2 Case 2. It forms part of the broader group of anorectal abscesses. The anorectal ring lies approximately ,5 cm above the linea dentata.

The Radiology Assistant : Rectum – Perianal Fistulas

In these cases the connection with the original fistula tract to the bowel is lost. Distance of the mucosal defect to the perianal skin on coronal images. Perianal abscess refers to a formed infective-inflammatory collection within the perianal region. Abscess in the Ischioanal space An abscess in the ischioanal space with no connection to the sphincter complex.


Seton fistulotomy is a technique where a rubber ligature or vessel loop is pulled through the fistula, it then is tightened every 2 weeks or so in order to obtain pressure necrosis so that the Seton is slowly pulled through the muscle. Case 4 Case 4. The most common fistulas are the intersphincteric and the transsphincteric.

A superficial fistula is a fistula that has no relation to the sphincter or the perianal glands and is not part of the Parks classification. T2W images without fatsat better display the anatomy, while the fatsat images better depict the fistulas.

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The puborectal muscle has its origin on both sides of the pubic symphysis, forming a ‘sling’ around the anorectum. The defect through the internal and external sphincter at 6 o’clock is clearly visible and more apparent on the fat sat images.

Synonyms or Alternate Spellings: Check for errors and try again. It is therefore abscdsso the sphincter complex and extrasphincteric. These three layers are continuous cranially with the puborectal muscle and levator ani figure. The drawing on the left illustrates the anal clock, which is the surgeon’s view of the perianal region when the patient is in the supine lithotomy position 2. Edit article Share article View revision history.


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It relaxes during defecation. An intersphincteric fistula is located at 6 o’clock. Extrasphincteric fistula On the left coronal T2W-images of a small abscess in the left ischioanal fossa, the fistula runs through the levator ani. On the left axial T2W-fatsat images of a transsphincteric fistula with the mucosal opening at 11 o’clock. Case 1 Case 1. While some abscesses may resolve spontaneously via internal drainage into the anal canal, others may require surgical incision and drainage.

Case 9 Case 9.

Case 6 Case 6. This has the advantage that the muscle is slowly cut and fibroses at the same time in order to cause as little damage as possible to the sphincter complex.

This scheme corresponds to the orientation of axial MR images of the perianal region. Articles Cases Courses Quiz. This is the circular upper border of the puborectal muscle which is digitally palpable upon rectal examination. Axial fatsat images depict the transmural inflammation with infiltration of the mesenteric fat. On the left an example of a complex fistula.