Topic: Applied anatomy of diaphragm, perineum and inguinal region.
Question: Describe the boundaries of ischiorecctal fossa. Provide a brief note on the clinical importance
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The ischiorectal fossa (ischiorectal space) is a wedge-shaped space located on each side of the rectum, anal canal, and perianal region. It has the following boundaries:
– Medially – Medial wall is formed by the fascia over the levator ani muscle and the anal canal.
– Laterally – Boundary is the obturator internus muscle covered by the obturator fascia.
– Anteriorly – Formed by the perineal body.
– Posteriorly – Boundary is the gluteus maximus muscle and sacrotuberous ligament.
– Base – Formed by the skin of the perianal region.
– Apex – Located at the level of the levator ani muscle.
Clinical importance:
– Abscesses and infections can develop in the ischiorectal fossa. Drainage may be required.
– Fistulas-in-ano commonly track through the ischiorectal fossa from the anal canal.
– Tumors like rectal cancers can invade into the ischiorectal fossa.
– Surgeons performing procedures like hemorrhoidectomy utilize the space for access.
– Anesthetic agents are injected into the fossa to provide regional analgesia for anorectal procedures.
– The fossa is examined during a digital rectal exam to check for masses or tenderness indicating underlying disorders.
