Magnetic resonance imaging for primary fistula <i>in ano</i>

Buchanan, G. N.; Halligan, Steve; Williams, Andrew B.; Cohen, C. Richard G.; Tarroni, D; Phillips, R. K. S.; Bartram, Clive I.

doi:10.1002/bjs.4125

Cited by 79 publications

(32 citation statements)

References 16 publications

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“…Some methods have been used to this end: fistulography, magnetic resonance imaging, CT, and endoanal ultrasound scanning (7)(8)(9)(10)(11)(12). Ultrasound scanning with hydrogen peroxide enhancement is a scarcely invasive, easy to perform and low cost test when compared to other methods.…”

Section: Discussionmentioning

confidence: 99%

Is routine endoanal ultrasound useful in anal fistulas?

Migueláñez¹,

Garcı́a-Olmo²,

Martínez-Puente³

et al. 2005

Rev. esp. enferm. dig.

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Objective: to evaluate the effectiveness of endoanal ultrasound with hydrogen peroxide enhancement in the assessment of anal fistula (tract and internal opening), and to value the utility of this examination for anal or perianal suppuration when performed by a colorectal surgeon trained in this technique.Patients: endoanal ultrasound was performed in 103 patients with anal or perianal suppuration. Twenty patients were excluded: 9 had the external opening closed, and 11 had cryptoglandular abscesses. All ultrasound scans were performed by the same explorer using a B&K Diagnostic Ultrasound System with a 7 MHz endoprobe. The examination was based on the identification of the three anal planes, then hydrogen peroxide was infused and the procedure was repeated.Results: out of 83 patients included, 11 had a perianal sinus and 72 an anal fistula. In all fistulas the main tract was found: 24 were inter-sphinteric (33.33%), 33 trans-sphincteric (45.83%), 3 supra-sphincteric (4.17%), and 12 extra-sphincteric (16.67%). An internal opening was identified in 69 (95.83%).Conclusions: endoanal ultrasound with hydrogen peroxide enhancement is an effective examination to visualize fistulous tracts and internal openings. We think it is highly useful for anal or perianal suppuration to identify abscesses, to recognize a perianal sinus, to check the sphincteric condition, and to plan subsequent surgery.

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Section: Discussionmentioning

confidence: 99%

Is routine endoanal ultrasound useful in anal fistulas?

Migueláñez¹,

Garcı́a-Olmo²,

Martínez-Puente³

et al. 2005

Rev. esp. enferm. dig.

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“…Ayrıca cerrahi sırasında fekal inkontinans gibi önemli bir morbid komplikasyonun oluşmaması için eksternal sfinkter bütünlüğünü korumak gerekmektedir [1,4,12]. En uygun cerrahi stratejinin belirlenmesinde ve rekürrens-komplikasyon oranlarının azaltılmasında preoperatif görüntülemeyle fistül sınıflandırılması S a y f a | 4 yapılması ve komşu anatomik yapıların gösterilmesi oldukça önemlidir [13,14].…”

Section: Discussionunclassified

Perianal fistülün tanısında, sınıflandırılmasında ve değerlendirilmesinde Manyetik Rezonans Görüntüleme’nin önemi

Koplay¹,

Sivri²,

Nayman³

et al. 2017

Archives of Clinical and Experimental Medicine

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Öz Amaç: Manyetik rezonans görüntüleme (MRG) perianal bölgenin değerlendirilmesinde yüksek güvenilirliğe sahip non-invaziv bir yöntemdir. Bu çalışmada, perianal fistül tanısı alan hastaların preoperatif MRG bulguları ve özellikle sınıflandırmanın görüntülerle birlikte sunulması amaçlandı. Yöntemler: Perianal fistül tanısı alan 57 hastanın demografik özellikleri ve kontrastlı konvansiyonel ve difüzyon MRG bulguları retrospektif olarak değerlendirildi. Perianal fistül sınıflandırılması MRG bulgularını temel alan 'St James Üniversite Hastanesi (SJUH) Sınıflaması' referans alınarak yapıldı. Bulgular: Çalışmaya 57 hasta (44 erkek ve 13 kadın: yaş aralığı 18-72 yıl; ortalama yaş 45,7 yıl) dahil edildi. Hastaların büyük çoğunluğunun esas yakınması makatta ağrı ve akıntı idi. Bazı hastalar ek olarak makatta kaşıntı, şişlik ve kızarıklık semptomları da bildirdi. 37 hastada tip 1, dokuz hastada tip 2, dört hastada tip 3, beş hastada tip 4, iki hastada ise tip 5 fistül saptandı. Anal kanala açılım yerleri 21 hastada saat 6, 10 hastada saat 7 olarak saptandı. Konvansiyonel ve difüzyon MRG ile fistül traktı, apse varlığı, rektuma açılım yeri, sfinkterle veya komşu anatomik yapılarla ilişkisi tüm hastalarda net olarak değerlendirildi. Sonuç: Anal kanal ve perine derisi arasında meydana gelen anormal bağlantı perianal fistül olarak adlandırılmaktadır. Genellikle tekrarlayan anorektal apselerin komplikasyonudur. Crohn, tüberküloz, malignite gibi inflamatuar süreçlere sekonder de gelişebilir. Tedavide esas yöntem cerrahidir. Cerrahi yetersizliğine bağlı rekürrens oldukça sıktır. MRG bulgularının iyi bilinmesi ve cerrahın iyi yönlendirilmesi ile rekürrens oranı en aza indirgenebilmektedir. Anahtar Kelimeler: Manyetik rezonans görüntüleme, Perianal fistül Abstract Aim: Magnetic resonance imaging (MRI) is a non-invasive and high reliability procedure for evaluation of perianal area. In this study, our purpose is to present preoperative MRI findings and classification with images in diagnosed perianal fistula patients. Methods: Contrast enhanced (CE) conventional MRI images, diffusion weighted MRI images and demographics of 57 patients were retrospectively evaluated. Perianal fistula classification is based on St James University Hospital (SJUH) classification system. Results: 57 patients (44 men and 13 women, average of 18 to 72 years, average age of 45.7 year) were included in this study. Most of the patients had symptoms of rectal pain and discharge. Some patients had additional complaints like rectal itching, swelling and erythema. 37 patients had grade 1, nine patients had grade 2, four patients had grade 3, five patients had grade 4 and two patients had grade 5 fistula. Fistula opening positions into anal canal were 6 o'clock in 21 patients, 7 o'clock in 10 patients. Fistula tract, its opening position into anal canal, presence of abscess and its relationship with sphincters or neighboring anatomical structures were clearly appreciated with conventional and diffusion weighted MRI in all patients. Conclusion: Perianal fistula i...

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“…The exact choice of modality depends on local expertise, cost, and available equipment [12][13][14][15][16][17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

A new minimally invasive treatment for anal fistula

Zhu

Shen

Wang³

et al. 2014

Front. Med.

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In colorectal surgery, eradicating the fistula and maintaining continence are still complex challenges for a colorectal surgeon. A minimally invasive method using a novel device was performed to consecutively treat 14 patients with anal fistula from August 2008 to November 2009. After a follow-up period of 36 months, 13 patients achieved successful closure of their fistula tracts, and recurrence occurred only in one patient. Recurrence was due to the delay of dressing change. No patient had interference with continence, and no major intra- and postoperative complications were identified. Using the novel device with invasive methods can be a promising alternative for managing anal fistulas.

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Magnetic resonance imaging for primary fistula in ano

Abstract: In experienced hands, MRI has a therapeutic impact of 10 per cent for primary fistula in ano, precipitating surgery that is likely to reduce recurrence in a small, but important, proportion of patients.

Cited by 79 publications

References 16 publications

Is routine endoanal ultrasound useful in anal fistulas?

Is routine endoanal ultrasound useful in anal fistulas?

Perianal fistülün tanısında, sınıflandırılmasında ve değerlendirilmesinde Manyetik Rezonans Görüntüleme’nin önemi

A new minimally invasive treatment for anal fistula

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