A 28 years female presented with discharge in the perineal area from 1 month. No history of previous surgeries and comorbidities. On examination of the perianal region, 2 external openings were noted
at 11° and 1° clock positions and on per rectal examination internal opening was noted in the 12° clock position 1cm from the anocutaneous junction. MRI fistulogram showed bilateral intersphincteric perianal fistula communicating with each other and a common internal opening at midline anteriorly at 12° clock position. Patient was posted for surgery and fistulotomy was done. Patient was discharged on 2nd day and is being followed on outpatient basis. Wound healing was noted at the 2nd week. Since anterior horse shoe shaped fistulas are rare we present this case report.
Keywords: Horse Shoe Fistula; Goosalls Rule; Fistulotomy.