Point-of-care Transperineal Ultrasound to Diagnose Abscess in the Emergency Department

Shokoohi, Hamid; Pyle, Matthew; Frasure, Sarah E.; Dimbil, Ubah; Pourmand, Ali

doi:10.5811/cpcem.2019.6.43514

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Many different imaging modalities have been tried in the past, out of which ultrasonography is the most convenient and readily available investigation. Trans-anal ultrasound is often difficult to tolerate by patients in an already existing painful condition, however transcutaneous perineal ultrasound can offer diagnostic advantage in superficially assessing location and loco-regional extent of collection specially in emergency cases [ 9 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Diffusion-Weighted MRI in Perianal Abscess: Role and Comparison With Contrast-Enhanced MRI

Aggarwal,

Malik,

Sarawagi

et al. 2024

Cureus

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Background: Perianal abscess is a clinical infective and/or inflammatory collection in the perianal region, one entity of a large group of anal and perianal disorders. Perianal abscesses are often seen as a complication of grade 2 and grade 4 perianal fistulas from St. James’s University Hospital classification. Several imaging modalities have been tried in the past for adequate assessment of perianal abscess with contrast-enhanced magnetic resonance imaging (CE-MRI) providing the most accurate results. Diffusion-weighted imaging (DWI) is an emerging sequence that can provide comparable results to CE-MRI in diagnosing and characterizing perianal abscess. The main objective of this study is to assess the role of DWI in adequate identification and assessment of perianal abscess and compare the final results with contrast-enhanced images. Methods: Twenty patients with complicated perianal fistula with clinically suspected perianal abscess were evaluated with DWI and CE-MRI. This study was a comparative cross-sectional study conducted in the Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Bhopal, India. Chi-square test was done to find the association between categorical variables. Kappa test was used to find the agreement between two different tests. Receiver operating characteristics (ROC) analysis was done to estimate the area under the curve in predicting the outcome. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were used to measure the validity of the tests. Results: DWI is a very sensitive MRI sequence and is equivalent to CE-MRI to detect the location and analyzing the loco-regional extent of abscess in complicated perianal fistula cases. DWI is also very sensitive and superior to T2 short tau inversion recovery (STIR) in differentiating perianal abscess from perianal inflammation without abscess. Conclusion: DWI can be used as an alternative to post-contrast fat-suppressed MRI in precisely defining the location and extent of anal and perianal abscesses and disease activity in complicated fistula cases.

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Section: Discussionmentioning

confidence: 99%

Diffusion-Weighted MRI in Perianal Abscess: Role and Comparison With Contrast-Enhanced MRI

Aggarwal,

Malik,

Sarawagi

et al. 2024

Cureus

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“…The advantages of this technique are multiple, but the results are highly operator sensitive due to the complex anatomy of the involved region and the substantial variability in patient presentation and location of rectal abscesses. In recent review, sonography demonstrated high accuracy in the identification of perianal abscesses [20], but the available evidence is too scarce to make a recommendation.…”

Section: B -In Patients With a Suspected Anorectal Abscess What Are The Appropriate Imaging Investigations?mentioning

confidence: 99%

Anorectal emergencies: WSES-AAST guidelines

et al. 2021

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Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management. While most of the underlying conditions do not need inpatient management, some of them could be life-threatening and need prompt recognition and treatment. It is well known that an incorrect diagnosis is frequent for anorectal diseases and that a delayed diagnosis is related to an impaired outcome. This paper aims to improve the knowledge and the awareness on this specific topic and to provide a useful tool for every physician dealing with anorectal emergencies.The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the boards of the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the WSES-AAST-WJES Consensus Conference on Anorectal Emergencies, and for each statement, a consensus among the WSES-AAST panel of experts was reached. We structured our work into seven main topics to cover the entire management of patients with anorectal emergencies and to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.

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Transperineal Ultrasound in the Diagnosis of Proctitis in the Emergency Department

Mulhim

Schulwolf

McFadden

et al. 2021

The Journal of Emergency Medicine

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Point-of-care Transperineal Ultrasound to Diagnose Abscess in the Emergency Department

Cited by 4 publications

References 18 publications

Diffusion-Weighted MRI in Perianal Abscess: Role and Comparison With Contrast-Enhanced MRI

Diffusion-Weighted MRI in Perianal Abscess: Role and Comparison With Contrast-Enhanced MRI

Anorectal emergencies: WSES-AAST guidelines

Transperineal Ultrasound in the Diagnosis of Proctitis in the Emergency Department

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