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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On the left axial T2W-fatsat absceso of a transsphincteric fistula with the mucosal opening at 11 o’clock. 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. In the tract there is a linear structure with a low signal intensity.

Position of the mucosal opening on axial images using the anal clock. There is no relation with the sphincter complex. The mucosal defect, which is by definition in the rectum, is abbscesso surgically closed. Continue with coronal images.

Support Radiopaedia and see fewer ads. The extrasphincteric fistula is uncommon and only pperianal in patients who had multiple operations. Case 6 Case 6. On the left an example of a complex fistula.


On the coronal image the fistula runs caudally towards the skin. T2W images without fatsat better display the anatomy, while the fatsat images better depict the fistulas. It is therefore above the sphincter complex and extrasphincteric. It forms part of the broader group of anorectal abscesses. Case 5 Case 5. The causes of perianal fistulas: Pathology Infection and anal gland drainage obstruction from the perianal fistula may lead to an acute perianal abscess.

The anal sphincter is comprised of three layers: The puborectal muscle has its origin on both sides of the pubic symphysis, forming a ‘sling’ around the anorectum. On the left a patient with a perianal fistula who has Crohn’s disease.

On the left coronal images of another patient with an intersphincteric fistula. Secondary fistulas or abscesses. No fistula was seen. The anatomical anal canal extends from the perineal skin to the linea dentata. The defect through the internal and external sphincter at 6 o’clock is clearly visible and more apparent on the fat sat images.

Perianal abscess | Radiology Reference Article |

Surgically, the anal canal extends from the perineal perinal to the anorectal ring. The right sided tract runs over the puborectal muscle asterisk and the mucosal opening lies at the level of the linea dentata black arrow. Continue with the coronal images.


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

Rectum – Perianal Fistulas

Proctitis On the left images of a patient who presented with anal complaints. An intersphincteric fistula is ahscesso at 6 o’clock. On the left coronal T2W-images of a small abscess in the left ischioanal fossa, the fistula runs through the levator ani. The causes of perianal fistulas:. The most widely used classification is the Parks Classification which distinguishes four kinds of fistula: If there is an extrasphincteric fistula, the lower part is perisnal. Distance of the mucosal defect to the perianal skin on coronal images.

There is a small abscess just above the nates.

Perianal suppuration: results of treatment.

Radiographics full text – Pubmed citation. A perianal fistula is an abnormal connection between the epithilialised surface of the anal canal and the skin.

Absceszo patient was already known to have an intersfincteric fistula, the mucosal defect is at 1 o’clock. Loading Stack – 0 images remaining. Complex fistula On the left an example of a complex fistula.