Introduction Communication between rectum and perianal skin Generally located within 3 cm of the anal margin Usually caused by anal crypt infection with abscess / extension formation Common in Crohn's disease Goodsall's Rule - fistulas originating anterior to transverse line with tract straight and anterior posterior to transverse line with curve and exit posterior Presentation Symptoms intermittent or constant discharge perirectal abscess itching Evaluation Anoscope Treatment Fistulotomy