57-year-old male with history of complex ischiorectal fistula. PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Subcentimeter lower pelvic and external iliac nodes.BOWEL, MESENTERY: Again seen is a complex fistula with multiple branching sinus tracts arising from the 1:00 position of the lower rectum. There is a moderate amount of fibrosis around the origin of the fistula. The first branch terminates on the skin surface of the midline gluteal cleft. The sinus tract then branches into anterior and posterior components. The anterior components heads towards the scrotum. The posterior component courses to the skin surface at the right gluteal cleft. The tracts are wider and more prominent when compared to prior.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Worsening complex ischiorectal fistula as above.