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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Case 4 Case 4. The causes of perianal fistulas:.

There is, however, a diffuse thickening of the rectal mucosa due to a proctitis. You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The puborectal muscle is contracted at rest and accounts for the 80? Case 7 Case 7. The mucosal defect, which is by definition in the rectum, is then surgically closed.

There is no relation with the sphincter complex.

On the left a patient with a perianal fistula who has Crohn’s disease. Position of the mucosal opening on axial images using the anal clock. There are two tracts in the ischioanal region. There is no connection with the peeianal sphincter.

Thank you for updating your details. On the left an example of a complex fistula. The abbscesso through the internal and external sphincter at 6 o’clock is clearly visible and more apparent on the fat sat images. One ends blindly in the intersphincteric space no. 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. Extrasphincteric fistula On the left coronal T2W-images of a small abscess in the left aabscesso fossa, the fistula runs through the levator ani.


Classification The most widely used classification is the Parks Classification which distinguishes four kinds of fistula: While some abscesses may resolve spontaneously via internal drainage into the absfesso canal, others may require surgical incision and drainage.

The right sided tract runs over the puborectal muscle asterisk and the mucosal opening lies at the level of the linea dentata black arrow. Synonyms or Alternate Spellings: Surgically, the anal canal extends from the perineal skin to the anorectal ring. If there is an extrasphincteric wbscesso, the lower part is opened.

Rectum – Perianal Fistulas

Crohn’s disease On the left a patient with a perianal fistula who has Crohn’s abscfsso. On the left coronal images of another patient with an intersphincteric fistula. It is therefore above the sphincter complex and extrasphincteric. Case 9 Case 9.

Log in Sign up. The anorectal ring lies approximately ,5 cm above the linea dentata. Intersphincteric fistula On the left axial T2W images with and without fat saturation.

The Radiology Assistant : Rectum – Perianal Fistulas

Case 1 Case 1. The causes of perianal fistulas: These are more often due to Crohns disease or anorectal procedures such as haemorrhoidectomy or sphincterotomy. absceseo

About Blog Go ad-free. On the left axial T2W images with and without fat saturation. Secondary Iatrogenic hemorrhoideal surgery Inflammatory bowel diseases Crohn’s abscessi more common than colitis ulcerosa Infections viral, fungal or TB Malignancy.

Perianal suppuration: results of treatment.

In the intersphincteric space it divides again into two tracts no. Sinus pilonidalis On the left an example of a sinus pilonidalis. A perianal fistula is an abnormal connection peerianal the epithilialised surface of the anal canal and the skin. The puborectal muscle has its origin on both sides of the pubic symphysis, forming a ‘sling’ around the anorectum.


Infection and anal gland drainage obstruction from the perianal fistula may lead to an acute perianal abscess.

Loading Stack – 0 images remaining. On the coronal image the fistula runs caudally towards the skin. In the tract there is a linear structure with a low signal intensity. Two tracts in the left buttock form a single tract no.

The treatment given depends on the anatomy of the fistula, if it is a simple fistula with a low mucosal defect is can be probed in the OR pdrianal identify the mucosal defect at the linea dentata, then the tract can be opened. This scheme corresponds to the orientation of axial MR images of the perianal region. This is the Seton which was inserted to treat the fistula.

Axial fatsat images depict the absceso inflammation with infiltration of the mesenteric fat. The extrasphincteric fistula is uncommon and only seen in patients who had multiple operations.

The other breaks through the internal sphincter with the mucosal defect at 1 o’clock. Support Radiopaedia and see fewer ads. 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.

Primary Obstruction of anal gland which leads to stasis and infection with absces and fistula formation most common cause.