Anal endosonography in the evaluation of perianal sepsis and fistula <i>in ano</i>

Law, Penelope; Talbot, R. W.; Bartram, Clive I.; Northover, J. M. A.

doi:10.1002/bjs.1800760737

Cited by 166 publications

(91 citation statements)

References 9 publications

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“…One of theoretical limitations of non-contrast EAUS is difficulty discriminating between an active tract and scar tissue since both tissues appear hypoechoic on noncontrast EAUS [19] . The gas generated after H2O2 instillation makes the active tract hyperechoic.…”

Section: Kim Y Et Al Endoanal Ultrasound In Anal Fistulamentioning

confidence: 99%

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement

Kim¹,

Park²

2009

WJG

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AIM:To evaluate the effectiveness of three-dimensional endoanal ultrasound (3D-EAUS) in the assessment of anal fistulae with and without H2O2 enhancement. METHODS:Sixty-one patients (37 males, aged 17-74 years) with anal fistulae, which were not simple low types, were evaluated by physical examination and 3D-EAUS with and without enhancement. Fistula classification was determined with each modality and compared to operative findings as the reference standard. RESULTS:The accuracy of 3D-EAUS was significantly higher than that of physical examination in detecting the primary tract (84.4% vs 68.7%, P = 0.037) and secondary extension (81.8% vs 62.1%, P = 0.01) and localizing the internal opening (84.2% vs 59.7%, P = 0.004). A contrast study with H2O2 detected several more fistula components including two primary suprasphincteric fistula tracks and one supralevator secondary extension, which were not detected on non-contrast study. However, there was no significant difference in accuracy between 3D-EAUS and H2O2-enhanced 3D-EAUS with respect to classification of the primary tract (84.4% vs 89.1%, P = 0.435) or secondary extension (81.8% vs 86.4%, P = 0.435) or localization of the internal opening (84.2% vs 89.5%, P = 0.406).CONCLUSION: 3D-EAUS was highly reliable in the diagnosis of an anal fistula. H2O2 enhancement was helpful at times and selective use in difficult cases may be economical and reliable.

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Section: Kim Y Et Al Endoanal Ultrasound In Anal Fistulamentioning

confidence: 99%

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement

Kim¹,

Park²

2009

WJG

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“…The perianal fistulas/abscesses were classified using Park's classification system 14 and the American Gastroenterological Association (AGA) classification. 8 In particular, the diagnosis of an intersphincteric abscess was based on AUS findings showing that the hypoechoic area originating from the subepithelial or submucosal layer was confined to the intersphincteric space by the external anal sphincter, thus widening and distorting an otherwise narrow plane 3,13,15 (Fig. 1).…”

Section: Diagnosis Of Perianal Fistulas and Abscessesmentioning

confidence: 99%

Incidence and clinical outcomes of intersphincteric abscesses diagnosed by anal ultrasonography in patients with crohnʼs disease

Viganò

Losco

Caprioli

et al. 2011

Inflammatory Bowel Diseases

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“…Thus, an early diagnosis is essential and treatment should be attempted without delay in an effort to achieve satisfactory results. Endoanal ultrasonography (EAUS) is considered to be a reliable technique for the assessment of fistula-in-ano and useful for distinguishing the condition from other inflammatory and tumorous conditions that affect the region around the anal canal [7][8][9][10][11][12] . However, the role of EAUS in the diagnosis of mucinous adenocarcinoma arising from fistula-in-ano has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Endoanal Ultrasonography of Mucinous Adenocarcinoma Arising from Chronic Fistula-in-ano: Three Case Reports

Toyonaga¹,

Mibu²,

Matsuda³

et al. 2017

J Anus Rectum Colon

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Abstract:Mucinous adenocarcinoma arising in chronic fistula-in-ano is rare, and diagnosing it at an early stage is difficult. The role of endoanal ultrasonography in diagnosing the condition has not been discussed in the study. Herein, we report three cases of mucinous adenocarcinoma arising from anal fistulas in which endosonography played an important role in diagnosing malignant change. Three male patients with a 5-to 20-year history of anal fistula were referred to our hospital due to perianal induration, progressive anal pain, or mucopurulent secretion. In all three patients, endosonography revealed a multiloculated complex echoic mass with isoechoic solid components communicating with a trans-sphincteric fistula and sonographyguided biopsy under anesthesia revealed mucinous adenocarcinoma. All patients underwent abdominoperineal resection with lymph node dissection. One patient with a local recurrence died 3 years after surgery and two have remained disease-free for >6 years. These observations suggest that endosonography may be a reliable technique for the diagnosis of mucinous adenocarcinoma arising from chronic fistula-in-ano. Sonography-guided biopsy is useful for the definitive diagnosis of malignancy. Therefore, periodic endosonography assessment should be recommended for patients with persistent anal fistula, especially those with progressive clinical symptoms. Once malignancy is suspected, aggressive sonography-guided biopsy under anesthesia should be performed, which may enable an early diagnosis, curative treatment, and favorable long-term results.

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Anal endosonography in the evaluation of perianal sepsis and fistula in ano

Cited by 166 publications

References 9 publications

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement

Incidence and clinical outcomes of intersphincteric abscesses diagnosed by anal ultrasonography in patients with crohnʼs disease

Endoanal Ultrasonography of Mucinous Adenocarcinoma Arising from Chronic Fistula-in-ano: Three Case Reports

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Anal endosonography in the evaluation of perianal sepsis and fistula in ano

Cited by 166 publications

References 9 publications

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H2O2enhancement

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H2O2enhancement

Incidence and clinical outcomes of intersphincteric abscesses diagnosed by anal ultrasonography in patients with crohnʼs disease

Endoanal Ultrasonography of Mucinous Adenocarcinoma Arising from Chronic Fistula-in-ano: Three Case Reports

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Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement

Three-dimensional endoanal ultrasonographic assessment of an anal fistula with and without H₂O₂enhancement