PMC6039961_01
Peri-anal inspection during initial visit. There were two fistulous orifices between the anus and coccyx (arrows).
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Based on clinical examination, there were two fistulous orifices between the anus and coccyx with purulent discharge (Fig. 1).
Fistulography showed a complex supra-elevator track that is connected to the pre-sacral area and another track ending blindly behind the rectum (arrows). No connection between the track and the rectum or anus was identified.
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The connection between the track and the rectum or anus was not identified on fistulography (Fig. 2).
(A) Sagittal CT image before treatment. CT scan showed a lytic destruction of the sacrum and coccyx, with a low-density area in the pre-sacrococcygeal area, suggesting inflammatory fluid collection. (B) The sagittal CT image after treatment. Fluid collection in front of the sacrum was disappeared.
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A computed tomography (CT) scan of the whole body reveled a lytic destruction of the sacrum (S3-5) and coccyx, with a low-density area in front of the sacrum, suggesting fluid collection (Fig. 3A). A follow-up CT scan was carried out during treatment, and results showed that fluid collection in front of sacrum had disappeared (Fig. 3B).