Male 28 years old Reason: evaluate for perirectal/pelvic abscess History: Swelling, pain, erythema left buttock. History fistula in ano currently with seton in place. PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is a branching left perianal fistula that extends from approximately the 3:00 position in the anorectum with a component that extends anteriorly to the base of the penis and exits the skin surface at the midline near the base of the penis. There is a seton in place. A larger component extends posteriorly into the left gluteus fat medially but doesn't have a clear exit point to the skin. This tract terminates in an abscess measuring 3.4 x 2.3 cm.Separate from this, there is a focal area of signal abnormality measuring 1.4 x 2.2 cm posterior to the coccyx in the skin representing a second small abscess. This is localized to the subcutaneous tissues without extending to the underlying bone gastrointestinal tract. This is located at the superior aspect of the gluteal cleft.OTHER: No significant abnormality noted.
1.Findings of a large left perianal fistula with a blind-ending pocket in the left medial gluteal adipose tissue.