The role of transperineal ultrasonography in the assessment of the internal opening of cryptogenic anal fistula.

Abstract

PURPOSE:

The aim of this study was to assess the reliability of transperineal ultrasonography (TPUS) in the pre-operative identification of the internal opening of anal fistulas compared to conventional proctological examination and operative findings.

METHODS:

Forty-three patients with anal fistula were assessed by TPUS with and without the use of hydrogen-peroxide injection (E-TPUS) in an attempt to identify the internal opening. Results were compared to preoperative conventional examination and operative findings.

RESULTS:

Operative assessment showed an anterior internal opening in 29 patients (67.4%) and a posterior opening in 14 (32.6%). Compared to the operative findings, the agreement rate for the identification of the internal opening was 74.4% for physical examination alone, 93.0% for TPUS and 90.7% for E-TPUS. Physical examination was less accurate in detecting the internal opening than both TPUS (p=0.014) and E-TPUS (p=0.026).

CONCLUSIONS:

TPUS and E-TPUS are superior to physical examination in the identification of internal openings in anal fistulas. Hydrogen peroxide injection does not provide additional advantages.

• Authors: H Kleinübing Jr, J F Jannini, A C L Campos, M Pinho, L C Ferreira
• Journal: Techniques in coloproctology (Tech Coloproctol) Vol. 11 Issue 4 Pg. 327-31 (Dec 2007) ISSN: 1123-6337 [Print] Italy
• PMID: 18058065 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hydrogen Peroxide

Topics

• Adult
• Aged
• Female
• Humans
• Hydrogen Peroxide (administration & dosage)
• Injections
• Male
• Middle Aged
• Perineum
• Preoperative Care (methods)
• Rectal Fistula (diagnostic imaging, surgery)
• Reproducibility of Results
• Ultrasonography