RECENT TRENDS IN DIAGNOSIS AND MANAGEMENT OF PERIANAL FISTULA
Mohamed Aly Ibrahim Barakat;
Abstract
Fistulography does not diagnose abscesses in relation to fistulous tracts and the actual relation of the primary tract to the anal and perianal structures could not be defined.
Rectal ultrasonography could supply us with information about fistulous tracks especially intersphincteric and transsphincteric varieties. However it cannot detect extrasphincteric and suprasphincteric tracks or differentiate Secondary supralevator and infralevater tracks. Residual scars or defects will confuse ultrasonographic interpretation and differentiation from anal fistulae. Rectal ultrasonography is an inexpensive simple technique well tolerated by the patient, however more refinement and experience by the operator is needed for comprehensive assessment of difficult anal fistulae.
MRI is a real achievement in the diagnosis of difficult anal fistulae, tracts whether primary or secondary can be visualized, abscesses detected, definite relation to anal musculature as well as the levator ani muscles can be achieved.
MRI is without radiation hazards however it is highly expensive and so its routine use is not advised especially in the simple subcutaneous or low varieties which could be easily assessed by proctological examination further more these fistulae are commonly too short so that they escape MRI diagnosis.
Rectal ultrasonography could supply us with information about fistulous tracks especially intersphincteric and transsphincteric varieties. However it cannot detect extrasphincteric and suprasphincteric tracks or differentiate Secondary supralevator and infralevater tracks. Residual scars or defects will confuse ultrasonographic interpretation and differentiation from anal fistulae. Rectal ultrasonography is an inexpensive simple technique well tolerated by the patient, however more refinement and experience by the operator is needed for comprehensive assessment of difficult anal fistulae.
MRI is a real achievement in the diagnosis of difficult anal fistulae, tracts whether primary or secondary can be visualized, abscesses detected, definite relation to anal musculature as well as the levator ani muscles can be achieved.
MRI is without radiation hazards however it is highly expensive and so its routine use is not advised especially in the simple subcutaneous or low varieties which could be easily assessed by proctological examination further more these fistulae are commonly too short so that they escape MRI diagnosis.
Other data
| Title | RECENT TRENDS IN DIAGNOSIS AND MANAGEMENT OF PERIANAL FISTULA | Other Titles | الاتجاهات الحديثه فى نشخيص وعلاج الناسور الشرجى | Authors | Mohamed Aly Ibrahim Barakat | Issue Date | 2015 |
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