Abstract
Examination under anesthesia for anal fistula is a subtle art form in physical diagnosis. It requires a clear understanding of anorectal anatomy and the pleomorphism of cryptoglandular disease. A stepwise algorithm for the intraoperative physical diagnosis of anal fistula is recommended. “Complex fistula” may clearly benefit from adjunctive imaging with either ultrasound or magnetic resonance imaging. “Failure” to elucidate the anatomic trajectory of a fistulous tract intraoperatively is a complete misnomer. It is simply an indication that imaging may contribute to the successful resolution of the problem at hand. The individual advantages of ultrasound and MRI are discussed.
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Cologne, K.G., Villanueva-Herrero, J.A., Montaño-Torres, E., Ortega, A.E. (2014). Clinical Assessment and Imaging Modalities of Fistula in Ano. In: Abcarian, H. (eds) Anal Fistula. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9014-2_6
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