A 30-year-old male presents with recurrent perianal discharge and pain. Examination reveals an external cutaneous opening 2 cm from the anal verge at the 5 o'clock position. According to Goodsall's rule, what is the expected trajectory of the internal fistula tract?
Answer and explanation
Correct answer: C. A curved tract opening into the posterior midline of the anal canal
- Step 1: Goodsall's rule states that external fistula openings situated posterior to the transverse anal line follow a curved path to open in the posterior midline of the anal canal.
- Step 2: Openings anterior to the transverse anal line usually follow a straight radial tract to the corresponding internal crypt.
- Step 3: An opening at 5 o'clock is posterior, and therefore tracks to the posterior midline.
Answer
A curved tract opening into the posterior midline of the anal canal.
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