Abstract
Experience with intrarectal ultrasonography (IRUS) is limited for the evaluation of perianal sepsis. The purpose of this article is to report our experience with IRUS in evaluating 24 cases of suspected perianal abscess and fistula. IRUS was performed intraoperatively using a Brüel & Kjaer (Model #1846; Naerum, Denmark) endoanal ultrasound scanner with a 7-MHz transducer. After completion of the IRUS, careful anorectal examination and appropriate surgical therapy were performed. At surgery, 19/24 patients were found to have perirectal abscesses, with all 19 cases correctly identified preoperatively by IRUS. In 12 cases (63 percent), IRUS correctly defined the relationship between the abscesses and sphincters by Parks' classification. At surgery, internal openings of fistulous tracts were found in 14/19 cases, but IRUS identified only 4/14 (28 percent). In 6/24 cases, IRUS and clinical evaluation did not demonstrate a perirectal abscess. The role of IRUS in the evaluation of perirectal abscess is evolving. Certainly, uncomplicated abscesses can be managed without ultrasonography. However, IRUS can be an adjunct to careful evaluation of complex perianal suppurative disease.
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References
Hildebrandt U, Feifel G, Schwarz HP, Scherr O. Endorectal ultrasound: instrumentation and clinical aspects. Int J Colorectal Dis 1986;1:203–7.
Boscaini M, Masoni L, Montori A. Transrectal ultrasonography: three years' experience. Int J Colorectal Dis 1986:1:208–11.
Milsom J, Graffner H. Intrarectal ultrasonography in rectal cancer staging and in the evaluation of pelvic disease. Am Surg 1990;212:602–6.
Kramann B, Hildebrandt U. Computed tomography versus endosonography in the staging of rectal carcinoma. Int J Colorectal Dis 1986;1:216–8.
Hawley PR. Does rectal endosonography influence rectal cancer treatment? Int J Colorectal Dis 1986;1:224–6.
Senagore AJ, Milsom JW, Talbott TM, Muldoon JP, Mazier WP. Intrarectal ultrasonography in the staging and management of rectal tumors. Am Surg 1988;54:352–5.
Senagore AJ, Milsom JW, Senagore P, Mazier WP, Scholten DJ, Zydbel P. A comparison between intrarectal ultrasound and CT scanning in staging of experimental rectal tumors. J Surg Res 1988;44:522–6.
Mascagni D, Corbellini L, Urciuoli P, Di Matteo G. Endoluminal ultrasound for early detection of local recurrence of rectal cancer. Br J Surg 1989;76:1176–80.
Hildebrandt U. Preoperative staging of rectal cancer by intrarectal ultrasound. Dis Colon Rectum 1985;28:42–6.
Tio TL, Tytgat GN. Comparison of blind transrectal ultrasonography with endoscopic transrectal ultrasonography in assessing rectal and perirectal diseases. Scand J Gastroenterol 1986;21(Suppl 23):104–11.
Law PJ, Talbott RW, Bartram CI, Northover JM. Anal endosonography in the evaluation of perianal sepsis and fistula in ano. Br J Surg 1989;76:752–5.
Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. Br J Surg 1976;63:1–12.
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Cataldo, P.A., Senagore, A. & Luchtefeld, M.A. Intrarectal ultrasound in the evaluation of perirectal abscesses. Dis Colon Rectum 36, 554–558 (1993). https://doi.org/10.1007/BF02049861
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DOI: https://doi.org/10.1007/BF02049861