PERFACT procedure: A new concept to treat highly complex anal fistula

Figure 5 Management of a 22-year-old male patient by PERFACT procedure. He had a double horseshoe intersphincteric abscess and fistula. External opening is at 11 o’clock and the internal opening was not traceable intraoperatively. Electrocauterization was done at both anterior and posterior midline. The left upper picture shows the MRI and the right bottom picture was taken after the final cure (posterior horseshoe abscess shown by green color was at a higher level). Arrows in the upper left pictures show the position of the horseshoe abscess and tracts.