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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Sinus pilonidalis On the left an example of a sinus pilonidalis.

Perianal suppuration: results of treatment.

Secondary fistulas or abscesses. This fistula breaks through the external sphincter no.

Infection and anal gland drainage obstruction from the perianal fistula may lead to an acute perianal abscess. On the left an example of a complex fistula. No fistula was seen. The treatment given depends on the anatomy of abxcesso fistula, if it is a simple fistula with a low mucosal defect is can be probed in the OR sbscesso identify the mucosal defect at the linea dentata, then the tract can be opened.

On the left an example of a suprasphincteric fistula.

Rectum – Perianal Fistulas

The extrasphincteric fistula is uncommon and only seen in patients who had multiple operations. There is no connection with the external sphincter. A perianal fistula is an abnormal connection between the epithilialised surface of the anal canal and the skin.


This is the circular upper border of the puborectal muscle which periaanl digitally palpable upon rectal examination. There is, however, a peruanal thickening of the rectal mucosa due to a proctitis.

Case 5 Case 5. Case 3 Case 3.

One ends blindly in the abxcesso space no. You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. This has the advantage that the muscle is slowly asbcesso and fibroses at the same time in order to cause as little damage as possible to the sphincter complex.

Case abecesso Case 7. Primary Obstruction of anal gland which leads to stasis and infection with absces and fistula formation most common cause.

Case 6 Case 6. Support Radiopaedia and see fewer ads. The most widely used classification is the Parks Classification which distinguishes four kinds of fistula: T2W images without fatsat better display the anatomy, while the fatsat images better depict the fistulas. If there is an extrasphincteric fistula, the lower part is opened. This is only possible if the external sphincter is not involved.

The puborectal muscle has its origin on both sides of the pubic symphysis, forming a ‘sling’ around the anorectum. The agscesso sphincter is comprised of three layers: This patient was already known to have an intersfincteric fistula, the mucosal defect is at 1 o’clock. The mucosal defect, which is by definition in the rectum, is then surgically closed.

An intersphincteric perianql is located at 6 o’clock. Treatment is focussed on the elimination of the primary and secondary tracts, prevention of recurrence and to retain continence. Crohn’s disease On the left a patient with a perianal fistula who has Crohn’s disease.


Perianal abscess refers to a formed infective-inflammatory collection within the perianal region.

The Radiology Assistant : Rectum – Perianal Fistulas

The defect through the internal and external sphincter at 6 o’clock is xbscesso visible and more apparent on the fat sat images. There is a small abscess just above the nates. Edit article Share article View revision history. The anatomical anal canal extends from the perineal skin to the linea dentata. The total length of the surgical anal canal is about cm.

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About Blog Go ad-free. Continue with the coronal images. The causes of perianal fistulas:.

Perianal abscess | Radiology Reference Article |

Protocol A localizer in three directions is needed in order to align the T2 sequences axial and coronal to the anal periaal. The most common fistulas are the intersphincteric and the transsphincteric. Use the arrows to scroll through the images. Classification The most widely used classification is the Parks Classification which distinguishes four kinds of fistula: In these cases the connection with the original fistula tract to the bowel is lost.

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The causes of perianal fistulas: