Document Detail


Transperineal Ultrasonography (Tp-Us) In Perianal Crohn's Disease And Recurrent Cryptogenic Fistula-In-Ano.
MedLine Citation:
PMID:  23489598     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: Successful anal fistula care is aided by specialized imaging accurately defining the site of the internal opening and fistula type. Imaging techniques are complementary, designed to answer specific anatomical questions. There are limited data concerning the clinical value of transperineal ultrasound (TP-US) in both cryptogenic fistula-in-ano and perianal Crohn's disease (PACD). The aim of the study was to assess the accuracy of TP-US when compared with operative findings in patients with perirectal sepsis. METHOD: Patients with recurrent cryptogenic anal fistula and PACD referred for sonography were examined using TP-US by a single examiner blinded to the operative results. Fistulae were categorized by the Parks' classification predicting the site of the internal fistula opening. Ancillary horseshoe collections, abscesses and secondary tracks were defined. RESULTS: Fourteen patients with PACD and 27 patients with recurrent cryptogenic fistula-in-ano were analyzed with comparative images and operative data. Correlation of fistula type for cryptogenic and PACD patients respectively was 23/27 (85.2%) and 12/14 (85.7%), with a correlative internal opening site (when found at surgery) of 16/22 (72.3%) and 12/14 (85.7%). Misclassification of fistula type in cryptogenic cases occurred in the presence of ancillary abscesses with associated acoustic shadowing. In PACD patients, TP-US was used when anal stenosis precluded endoanal ultrasonography, assisting in the diagnosis of rectovaginal fistulae. CONCLUSION: Transperineal ultrasound is a useful complementary technique to assess fistula-in-ano and has special advantage when there is anal canal distortion, complex fistula type or suspicion of a rectovaginal fistula. © 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of GreatBritain and Ireland.
Authors:
Avinoam Nevler; Marc Beer-Gabel; Alex Lebedyev; Assaf Soffer; Dan Carter; Andrew P Zbar
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-12
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  -     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Authors. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.
Affiliation:
Department of Surgery and Transplantation, Chaim Sheba Medical Center Tel Hashomer Hospital, Ramat Aviv, Israel.
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