Abstract
SUMMARY Perineal impalement injuries are rare and can produce a chronic perineal discharge not caused by the usual fistula or perianal abscess. We report a 34 year-old man who suffered a perineal impalement in an accident at work and presented with almost continuous perianal purulent discharge for five years. He was treated as a perianal fistula, with partial fistulectomy and elastic bandage, without improvement. CT guided fistulography and colonoscopy with methylene blue and hydrogen peroxide injection into the fistula demonstrated no rectal connection. Surgical exploration was then performed, extracting a foreign body, corresponding to a piece of fabric. Complete closure of the external fistulous opening was achieved in two weeks. The final follow-up examination was performed one month after surgery.
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