Official websites use. Share sensitive information only on official, secure websites. Correspondence to: Guillermo P. A broad spectrum of pathology affects the rectum, anus and perineum, and multiple imaging modalities are complementary to physical examination for assessment and treatment planning. Key anatomic and surgical concepts are discussed, including radiological information desired for surgical planning, and current operative approaches to these anatomic spaces to assist the practicing radiologist for comprehensive reporting that can aid the gastroenterologists and surgeons.
Keywords: Rectum, anorectal, Fournier gangrene, anal fistula, Computed tomography, magnetic resonance imaging. Acute and chronic conditions affecting the anus, rectum, and perineum are often clinical diagnoses in adults. Imaging may play a role in surgical planning and diagnosis for those entities that are not readily apparent on physical exam.
With the expanding use of CT in the acute setting, such acute anorectal and perineal conditions may be images on CT. MR offers superior spatial resolution and is used in selected conditions to delineate anatomy and extent of disease, such as anorectal fistula, which may not be readily apparent on physical exam. In pediatrics, imaging plays an obvious role in delineating aberrant anatomy that may need surgical correction.
A review of infectious, inflammatory, and vascular conditions such as perirectal abscess, Fournier gangrene, rectal manifestations of inflammatory bowel disease, vascular malformation, among others, is presented. Congenital anomalies and conditions that present in infants and adults are presented as well.
The purpose of this of this pictorial essay is to describe imaging findings of various anorectal and perineal conditions and provide endoscopic and surgical correlation when applicable. Purulent collections or fistulous tracts can occur in the potential spaces around the rectum and anus Figure 1a. Anorectal abscesses and fistulae represent a spectrum of disease: the two entities may occur independently or in conjunction with each other.
