Coloperineal Fistula

Abstract

The patient complained of attacks of lower abdominal pain for 7 years. An intermittently discharging abscess in the right ischiorectal fossa had been present for 1 year (Figure 41.1). The referring doctor had been able to pass a probe into the abscess for a depth of 12cm. A sinogram demonstrated a connection with the sigmoid colon in which there was extensive diverticular disease. Rectal examination revealed marked induration anteriorly and laterally around the rectum at the level of the prostate. Rigid sigmoidoscopy revealed no pathology to 16cm. A barium enema confirmed the findings of the sinogram (Figure 41.2).