History of proctitis with persistent rectal bleeding and pain. Transrectal ultrasound showing a 2 mm perianal fistula. Evaluate extent of disease prior to surgical treatment. PELVIS:PROSTATE/SEMINAL VESICLES: Prostate is normal in size.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a fistula arising from the 1:00 position of the anal verge distal to the sphincter and extending through the medial left gluteal soft tissues and exiting the skin along the inferior aspect of the major gluteal fold (series 1202 images 21 through 11). No involvement of the sphincter is identified. The tract appears well granulated. No associated abscess is identified.BONES, SOFT TISSUES: Fat containing left inguinal lymph node. Edema and ill-defined enhancement in the right vastus lateralis muscle; correlate with history of trauma (series 1202 image 12).OTHER: No significant abnormality noted.
1.Perianal fistula arising distal to the sphincter at the anal verge extending into the left gluteal soft tissues as described. No associated underlying abscess is identified.