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General Surgery · Colorectal surgery: anal fistula
Sample itemA patient has recurrent perianal abscesses and persistent purulent drainage from a small opening near the anus. What diagnosis is likely?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Fistula-in-ano
Fistula-in-ano is an abnormal tract between anal canal and perianal skin, often following cryptoglandular abscess. Mapping sphincter involvement is important before definitive surgery.
Option by option
A. Fistula-in-ano (correct)
Correct. Recurrent abscess and chronic drainage are classic for anal fistula.
B. Anal fissure
Anal fissure causes painful defecation and bleeding but not chronic pus drainage.
C. Rectal prolapse
Rectal prolapse is circumferential protrusion of rectum.
D. Pilonidal sinus
Pilonidal sinus occurs in the natal cleft.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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