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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Position of the mucosal opening absvesso axial images using the anal clock. The causes of perianal fistulas: One ends blindly in the intersphincteric space no. Any localizer that properly displays the anal canal can be used.

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 to identify the mucosal defect at the linea dentata, then the tract can be opened.

Crohn’s disease On the left a patient with a perianal fistula who has Crohn’s disease. Case 7 Case 7. An intersphincteric fistula is located at 6 o’clock.

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. 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.


Abscess in the Ischioanal space An abscess in the ischioanal space with no connection to the sphincter complex. It forms part of the broader group of anorectal abscesses.

The total length of the surgical anal canal is about cm. These three layers are continuous cranially with the puborectal muscle and levator ani figure. T2W images without fatsat better display the anatomy, while the fatsat images better depict the fistulas.

Perianal suppuration: results of treatment.

Continue with the coronal images. Protocol A localizer in three directions is needed in order to align the T2 sequences axial and coronal to the anal canal. On the perinaal axial T2W images with and without fat saturation. Axial fatsat images depict the transmural inflammation with infiltration of the mesenteric fat.

Primary Obstruction of anal gland which leads to stasis and infection with absces and fistula formation most common cause. The anorectal ring lies approximately ,5 cm above the linea dentata. Case 8 Case 8. It relaxes during defecation. There is a small abscess just above the nates. On axial and coronal MR-images the different layers of the anal sphincter and the surrounding structures can be displayed perfectly. Thank you for updating your details.


On the coronal image the fistula runs caudally towards the skin. In the intersphincteric space it divides again into two tracts no. On the coronal images the thickening of the bowel wall is demonstrated. It is therefore above the sphincter complex and extrasphincteric.

This patient was already known to have an intersfincteric fistula, the mucosal defect is at 1 o’clock.

Distance of the mucosal defect to the perianal skin on coronal images. There is, however, a diffuse thickening of the rectal mucosa due to a proctitis.

While some abscesses may resolve spontaneously via internal drainage into the anal canal, others may require surgical incision and drainage.

The Radiology Assistant : Rectum – Perianal Fistulas

Radiographics full text – Pubmed citation. The anatomical anal canal extends from absceesso perineal skin to the linea dentata. Use the arrows to scroll through the images. On the left a patient with a perianal fistula who has Crohn’s disease. Infection and anal gland drainage obstruction from the perianal fistula may lead to an acute perianal abscess.