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There are a range of sphincter-preserving procedures available to treat anorectal fistula, some of which can be precluded, or rendered more optimal by specific features of fistula anatomy. Magnetic resonance imaging (MRI) is the gold standard modality for assessing anorectal fistula. To maximise clinical utility, the MRI report should accurately describe these clinically relevant features. We aimed to develop a minimum dataset for reporting MRI of anorectal fistula, in order to improve the assessment and management of these patients. A longlist of 70 potential items for the minimum dataset was generated through systematic review of the literature. This longlist was presented to radiologists, surgeons and gastroenterologists in an online survey to understand the features that shape current clinical practice. The longlist and survey results were then presented to an expert consensus panel to generate the final minimum dataset through discussion and anonymous voting. The final minimum dataset details the general characteristics, features of the internal and external openings, path of the fistula through the sphincters and any associated extensions and collections that should be described in all MRI reports for anal fistula. Additional surgical and perianal Crohn’s disease subsets were developed to indicate the features that aid decision-making for these patients, in addition to a minimum dataset for the clinical request. This study represents a multi-disciplinary approach to developing a minimum dataset for MRI reporting of anal fistula, highlighting the most important features to report that can assist in clinical decision-making. Key Points • This paper recommends the minimum features that should be included in all MRI reports for the assessment of anal fistula, including Parks classification, number of tracts, features of the internal and external opening, path of the tract through the sphincters, the presence and features of extensions and collections. • Additional features that aid decision-making for surgery or in the presence of Crohn’s disease have been identified. • The items that should be included when requesting an MRI are specified.

Background Joint medical-surgical inflammatory bowel disease clinics allow simultaneous patient assessment by both a gastroenterologist and surgeon. However, patient perceptions of dual clinician presence have not been adequately assessed. Therefore, this study aimed to evaluate the patient's view of receiving multidisciplinary care in this clinic. Methods Patients attending the medical-surgical inflammatory bowel disease clinic completed questionnaires assessing their attitudes towards the clinic, their overall satisfaction and desired frequency of appointments. Results Responses were received from 44 patients, the majority of whom indicated that attendance at the joint medical-surgical clinical made them feel less anxious about their disease, provided consistent messages regarding their care and minimised the number of trips made to hospital. High levels of satisfaction were reported, with 43% stating they preferred joint clinic attendance for every appointment. Conclusions Effective inflammatory bowel disease management requires coordinated care across specialties. Simultaneous medical-surgical assessment has practical and emotional benefits, without making patients feel overburdened by the presence of more than one clinician. This supports the streamlining of care for patients with inflammatory bowel disease in specific clinical scenarios.

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