Comparison of accuracy of physical examination and endoanal ultrasonography for preoperative assessment in patients with acute and chronic anal fistula

Abstract

Endoanal ultrasonography is reliable and useful for preoperative assessment of anal fistula, particularly for detecting horseshoe extension and localizing the internal opening. Endosonographic assessment provides clearer depiction of the internal opening during periods of quiescence than during the period of abscess formation. For patients with acute anorectal sepsis, initial surgical drainage and subsequent fistula surgery, rather than one-stage fistula surgery, may be advisable to avoid misidentification of the internal opening.

Impact of three‐dimensional endoanal ultrasound on the outcome of anal fistula surgery: a prospective cohort study

“…The accuracy rate of EAUS is estimated as 80%-89% for delineating fistula tract, 91% for internal opening. EAUS is particularly accurate in identifying horseshoe abscess and its extension [5,[15][16][17][18]. Threedimensional ultrasound techniques provide even better imaging quality and orientation, with an accuracy rate comparable to that of MRI, especially for complex anal fistula [12,13,19,20].…”

Quality of life following surgery for recurrent fistula-in-ano

“…Despite the continuous improvement in preoperative imaging [2,3], the reported recurrence rates vary from 8 to as high as 40% [4]. Recurrent fistula-in-ano carries a significant morbidity affecting the quality of life (QOL) due to the disease as well as due to repeated operations [5].…”

Anal Canal Duplication Associated with Presacral Cyst in an Adult

“…Pelvic and abdominal ultrasound examinations are useful for evaluating the presence of associated anomalies in neonates, and MRI should be routinely used in older children and young adults because ultrasounds do not adequately visualize the intraspinal and presacral space in patients belonging to these age groups. EAUS is a reliable technique for the assessment of fistula-in-ano and is useful for distinguishing this condition from other inflammatory or tumorous conditions that affect the region around the anal canal 10,11) . In this study, EAUS with hydrogen peroxide injection revealed a brightly hyperechoic blind-ending fistulous tract without connection with the anal canal.…”