Transperineal ultrasonography in perianal Crohn's disease and recurrent cryptogenic fistula‐in‐ano

Abstract

TP-US is a useful complementary technique to assess fistula-in-ano and has special advantage when there is anal canal distortion, complex fistula type or suspicion of a recto-vaginal fistula.

Transperineal Perineal Ultrasound Versus Magnetic Resonance Imaging In the Assessment of Perianal Crohnʼs Disease

“…15,18,19 However, given its advantages in detecting anovaginal and rectovaginal fistulae and superficial lesions, TPUS could be a useful and practical complementary methodology to MRI. 15,18,19 However, given its advantages in detecting anovaginal and rectovaginal fistulae and superficial lesions, TPUS could be a useful and practical complementary methodology to MRI.…”

“…The American Gastroenterological Association (AGA) proposed a more practical approach, differentiating simple and complex fistulae, according to anatomical and clinical (skin orifices, anorectal stricture, proctitis) parameters. Transperineal ultrasound (TPUS) is a simple, widely available, painless, cheap, noninvasive technique already proposed to assess perianal fistulae and/or abscesses complicating CD [13][14][15][16][17][18] ; therefore, it could represent a useful and practical tool for screening and follow-up of perianal disorders complicating CD patients. 6 Therefore, to plan appropriate medical or surgical therapy, fistula anatomy should be accurately assessed and patients classified as having simple or complex perianal disease.…”

“…5 This classification has a proved prognostic value because patients with simple fistulae experience a better outcome compared with those with complex tracts. 15,18,19 Therefore, we evaluated the accuracy of TPUS in detecting and classifying perianal fistulae according to both Parks' classification and as simple or complex perianal disease, using MRI and surgical clinical assessment as the reference standard. 5,7 This relies on the accuracy of the diagnostic methods used to assess perianal disease.…”

Role of ultrasound in colorectal diseases

“…According to comparative studies, its sensitivity is comparable to that of rectal ultrasound and MRI in diagnosing perianal fistulas and abscesses[44-46] (Figure 4). Its availability and cost-effectiveness enable perianal ultrasound to monitor real-time recovery of fistulas, thus more expensive MRI might be avoided.…”

Application of Endorectal Ultrasound in Evaluation of Anorectal Diseases

“…When ERUS is performed, it is of vital important to accurately identify of the fistulas, the presence of secondary extension and the presence of abscess. The use of 3D-ERUS and addition of hydrogen peroxide and transperineal ultrasound can help display complex fistulas, especially for the perianal fistula CD [40,41] . ERUS is an available tool to monitor the effect of treatment in the therapy of perianal CD.…”