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A New Anatomical Pathway of Spread of Pus/Sepsis in Anal Fistulas Discovered on MRI and Its Clinical Implications
Author(s) -
Pankaj Garg,
Baljit Kaur,
Vipul D Yagnik,
Sushil Dawka
Publication year - 2021
Publication title -
clinical and experimental gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.113
H-Index - 30
ISSN - 1178-7023
DOI - 10.2147/ceg.s335703
Subject(s) - medicine , rectum , abscess , fistula , anal canal , surgery , radiology , anatomy
In the anal sphincter complex, the intersphincteric space between the internal and external sphincters is the only conventionally recognized pathway for the spread of sepsis. However, there is another unrecognized space discovered on MRI, the "outer-sphincteric space", between the external anal sphincter and its lateral fascia along which pus can spread. An abscess in the intersphincteric space is easily drained into the rectum via the transanal route and is more likely to spread into the supralevator space. Conversely, an abscess in the outer-sphincteric space is difficult to drain transanally into the rectum and is more likely to become a transsphincteric abscess/fistula.

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