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Updated: Sep 11, 2025

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Published on: July 11, 2013
Anal fistula with concomitant perianal cyst: A case report and literature review
Zhihan Jiang1, Kangze Wu2,3
1Department of Colorectal & Anal Surgery, Shaoxing Yuecheng People's Hospital, Shaoxing, PR China.
Rationale:
Recurrent anal fistula remains a clinical challenge, especially when standard treatment fails to prevent relapse. Adjacent cystic infections may represent an underrecognized contributor to persistent or recurrent disease.
Patient Concerns:
A patient with a long-standing history of perianal discomfort and multiple anal fistula recurrences presented with ongoing discharge and pain despite previous surgical interventions.
Diagnoses:
Clinical examination and intraoperative findings revealed a 2 × 2 cm infected cyst located adjacent to the recurrent anal fistula tract.
Interventions:
The patient underwent complete surgical excision of both the anal fistula and the adjacent infected cyst.
Outcomes:
Postoperative recovery was uneventful. The patient achieved sustained remission with no signs of recurrence observed during a 3-month follow-up period.
Lessons:
This case highlights a notable association between recurrent anal fistula and adjacent cystic infection. Cystic infection may serve as a hidden trigger for fistula reactivation and should be considered in patients with treatment-resistant perianal disease.
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