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Accuracy of hydrogen peroxide enhanced endoanal ultrasonography in assessment of the internal opening of an anal fistula complex.

AbstractBACKGROUND:
The aim of this study was to evaluate the accuracy of hydrogen peroxide-enhanced ultrasound in localizing the internal opening of the anal fistula.
METHODS:
A retrospective review of all patients with anal fistula who underwent hydrogen peroxide-enhanced ultrasound was performed. The results of hydrogen peroxideenhanced ultrasound and intraoperative findings on the basis of operative reports were correlated.
RESULTS:
A total of 57 patients (47 men) of mean age of 45.7 (range, 21-77) years underwent hydrogen peroxide-enhanced ultrasound with a diagnosis of anal fistula; 36 patients underwent surgery. The intraoperative internal opening correlated with the hydrogen peroxide-enhanced ultrasound report in 22 of 36 patients (61.1%). In 5 patients, the hydrogen peroxide-enhanced ultrasound yielded false-positive information with a positive predictive value of 84%. Four of the 7 patients with falsenegative hydrogen peroxide-enhanced ultrasound findings had supra- and extrasphincteric fistulas.
CONCLUSIONS:
There is a 61.1% correlation between hydrogen peroxide-enhanced ultrasound and surgical findings of the internal opening with a positive predictive value of 84%. If no internal opening was seen on hydrogen peroxide-enhanced ultrasound, it strongly suggests the possibility of a supralevator or extrasphincteric fistula.
AuthorsI Moscowitz, M K Baig, J J Nogueras, E Ovalioglu, E G Weiss, J J Singh, S D Wexner
JournalTechniques in coloproctology (Tech Coloproctol) Vol. 7 Issue 3 Pg. 133-7 (Oct 2003) ISSN: 1123-6337 [Print] Italy
PMID14628155 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Contrast Media
  • Hydrogen Peroxide
Topics
  • Adult
  • Aged
  • Contrast Media
  • Female
  • Humans
  • Hydrogen Peroxide
  • Male
  • Middle Aged
  • Rectal Fistula (surgery, ultrasonography)
  • Retrospective Studies
  • Sensitivity and Specificity

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