Perianal fistula: abscess | Radiology Case |

The fistula is an abnormal connection between two hollow structures. The fistula may be congenital or develops after surgery or injury of an organ.


  • Opening near sutures wound or any body part like anus or vagina.
  • Pus , fluid, waste leak from the opening.
  • Throbbing pain
  • Swelling near the affected area.


  • Hypersensitivity to contrast
  • Suspected pregnancy


  • Fluoroscopy unit with tilting table 
  • Local anesthesia
  • Catheter 
  • Contrast
  • Normal saline 
  • Gauze 
  • Sterile towel 
  • Antiseptic solution

Patient  preparation

  • The patient should not eat or drink after midnight.
  • Patient KFT reports must be reviewed prior to the examination.
  • Describe whole procedure to the patient.
  • Ask the patient to remove clothing and wear hospital gown. 
  • An IV line is inserted into the patient arm and sedative medication is given through line to make patient relax.


  • Place the patient on the X- ray Fluoroscopic table .
  • Clean the fistula with an antiseptic solution.
  • Local anesthesia is injected near the fistula for numbing the area.
  • Then the radiologist advances a catheter according to the size of fistula into the fistula tract.
  • After insertion of a catheter, the radiologist slowly injected 5ml diluted ionic contrast mixed with normal saline into the fistula tract under fluoroscopy guidance.
  •  After filling the fistula  tract with the contrast media, several x ray or spot films are taken in AP , Lateral and Oblique position to access the fistula tract.
  • After completion of examination the catheter is removed and the wound must be cleaned and covered with the dressing.


  • Patient will be allowed to leave the examination room after completion of the examination.