Management of cryptoglandular supralevator abscesses in the magnetic resonance imaging era: a case series

Abstract

Magnetic resonance imaging seems essential to clarify the location of supralevator abscess, its origin, and choice of the right drainage route. Subsequent treatment of the fistula is necessary to avoid recurrence.

The treatment of anal fistula: secondACPGBIPosition Statement – 2018

“…Indeed, where there is sepsis detected on MRI but not at EUA, MRI predicts recurrence of sepsis. Thus MRI improves clinical assessment by detecting previously missed secondary extensions and correctly assessing the level of fistula with respect to the sphincter complex . This may be further enhanced with novel three‐dimensional modelling systems to show the full extent of the sepsis in relation to the anal sphincter complex .…”

Supralevator abscess: New treatment for an uncommon aetiology: Case report

“…An adequate radiological characterization is important to avoid iatrogenic creation of a complex fistulae. Therefore, if an inter-sphincteric fistulae is present, the approach should be endorectal, in order to avoid supra-sphincteric fistulae [5,6]. Radiologic characterization may be achieved by pelvic MRI, endorectal ultrasound or pelvic CT, with the first two methods being considered the gold-standard [7].…”

Modified Pauli abdominal wall reconstruction for recurrent parastomal hernia after a Sugarbaker repair – a video vignette

“…The deep postanal space communicates on either side with the ischioanal fossa providing a pathway for abscess extension. A horseshoe extension with bilateral involvement of both ischioanal fossae secondary to a transsphincteric fistula is the most severe manifestation of this condition [3].…”