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This was the appearance of the buttocks in a 65 year old male who was referred to us with a history of a non healing perianal fistula for two years. Copious amounts of mucous discharge from the wound was observed. The patient had had a peri-anal abscess drained, which later developed into a fistula-in-ano. He had undergone several unsuccessful attempts at fistulectomy which ended in him having a defunctioning colostomy. There was no preceding history of rectal bleeding or altered bowel habits. The area was hard and tender on palpation. There were no tumours palpable on digital rectal examination.

Rare cause for a non healing perianal fistula in an elderly male