case_images: PMC9133505_01
case_images: Sagittal T2-weighted perineum MRI shows a 25- mm anal fistula (arrow).
case_images: fsurg-09-908390-g001.jpg
case_images: PMC9133505_01_fsurg-09-908390-g001.jpg
case_images: F1
case_images: Magnetic resonance imaging of the perineum showed an anal fistula between 1 and 3 o'clock in the lithotomy position (Figure 1).
case_images: Fistulography reveals a 25-mm-long tubular structure of about 1-3 mm in width without any connection with the rectum.
case_images: fsurg-09-908390-g002.jpg
case_images: PMC9133505_01_fsurg-09-908390-g002.jpg
case_images: F2
case_images: Fistulography revealed a 25-mm-long tubular structure of about 1-3 mm in width without connection with the rectum (Figure 2).
case_images: Perineal approach (prone position): the fistula had communication with the secondary anus, and this fact was checked with a metal catheter after intraoperative fistulography.
case_images: fsurg-09-908390-g003.jpg
case_images: PMC9133505_01_fsurg-09-908390-g003.jpg
case_images: F3
case_images: Intraoperative fistulography under pressure showed that there was connection between the fistula and the secondary anus and was checked with a metal catheter (Figure 3).
case_images: The resected specimen shows that the distal portion is a 40-mm-long duct.
case_images: fsurg-09-908390-g004.jpg
case_images: PMC9133505_01_fsurg-09-908390-g004.jpg
case_images: F4
case_images: ACD had a narrow fistula, measuring approximately 2 mm in diameter and 40 mm in length (Figure 4). A hemovac drain was inserted, and the muscles were approximated with absorbable sutures (Figure 5).
case_images: A hemovac drain is inserted, and the muscles are approximated with absorbable sutures.
case_images: fsurg-09-908390-g005.jpg
case_images: PMC9133505_01_fsurg-09-908390-g005.jpg
case_images: F5
case_images: ACD had a narrow fistula, measuring approximately 2 mm in diameter and 40 mm in length (Figure 4). A hemovac drain was inserted, and the muscles were approximated with absorbable sutures (Figure 5).
case_images: Histological findings (H&E). The duct is predominantly lined by squamous epithelium (white arrow) and smooth-muscle (black arrow).
case_images: fsurg-09-908390-g006.jpg
case_images: PMC9133505_01_fsurg-09-908390-g006.jpg
case_images: F6
case_images: Squamous epithelium in the distal end and smooth-muscle cells lined the wall were demonstrated on pathology (Figure 6).
case_images: One month after surgery, the wound healed completely.
case_images: fsurg-09-908390-g007.jpg
case_images: PMC9133505_01_fsurg-09-908390-g007.jpg
case_images: F7
case_images: One month after surgery, the wound healed completely (Figure 7).