Skip to main content
SpringerLink
Log in
Book cover

Anus pp 231–242Cite as

Imaging of Anal Sepsis

  • Chapter
  • First Online:

  • 1461 Accesses

Abstract

This chapter will explain the pathogenesis of anal sepsis with the focus on fistula-in-ano. It will detail the different types of fistula encountered, describe how they may be imaged and distinguished from one another and will explain how imaging affects surgical treatment and ultimate outcome. We emphasise that precise preoperative characterisation of the anatomical course of the fistula and all associated infection using imaging is critical if surgery is to be most effective. Most importantly, we will describe how MRI is the pre-eminent modality used to answer these pertinent surgical questions.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Chiari H. Uber die analen divertikel der rectumschleimhaut und ihre beziehung zu den anal fisteln. Wien Med Press. 1878;19:1482–3.

    Google Scholar 

  2. Parks AG. The pathogenesis and treatment of fistula-in-ano. Br Med J. 1961;5224:463–9.

    Article  Google Scholar 

  3. Fucini C. One stage treatment of anal abscesses and fistulae. Int J Colorectal Dis. 1991;6:12–6.

    Article  CAS  PubMed  Google Scholar 

  4. Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. Br J Surg. 1976;63:1–12.

    Article  CAS  PubMed  Google Scholar 

  5. Sanio P. Fistula-in-ano in a defined population: incidence and epidemiological aspects. Acta Chir Gynaecol. 1984;73:219–24.

    Google Scholar 

  6. Buchanan G, Halligan S, Bartram CI, Williams AB, Tarroni D, Cohen CRG. Clinical examination, endosonography, and magnetic resonance imaging for preoperative assessment of fistula-in-ano: comparison to an outcome derived reference standard. Radiology. 2004;233:674–81.

    Article  PubMed  Google Scholar 

  7. Halligan S, Buchanan G. Imaging fistula-in-ano. Eur J Radiol. 2003;42:98–107.

    Article  Google Scholar 

  8. Halligan S, Stoker J. Imaging fistula-in-ano: state-of-the-art. Radiology. 2006;239:18–33.

    Article  PubMed  Google Scholar 

  9. Beets-Tan RG, Beets GL, van der Hoop AG, Kessels AG, Vliegen RF, Baeten CG, van Engelshoven JM. Preoperative MR imaging of anal fistulas: does it really help the surgeon? Radiology. 2001;218:75–84.

    Article  CAS  PubMed  Google Scholar 

  10. Buchanan G, Halligan S, Williams A, Cohen CR, Tarroni D, Phillips RK, Bartram CI. Effect of MRI on clinical outcome of recurrent fistula-in-ano. Lancet. 2002;360:1661–2.

    Article  PubMed  Google Scholar 

  11. Hussain SM, Stoker J, Schouten WR, Hop WC, Lameris JS. Fistula in ano: endoanal sonography versus endoanal MR imaging in classification. Radiology. 1996;200:475–81.

    CAS  PubMed  Google Scholar 

  12. Halligan S, Bartram CI. MR imaging of fistula in ano: are endoanal coils the gold standard? AJR Am J Roentgenol. 1998;171:407–12.

    Article  CAS  PubMed  Google Scholar 

  13. Lunniss PJ, Armstrong P, Barker PG, et al. Magnetic resonance imaging of anal fistulae. Lancet. 1992;340:394–6.

    Article  CAS  PubMed  Google Scholar 

  14. Spencer JA, Ward J, Beckingham IJ, Adams C, Ambrose NS. Dynamic contrast-enhanced MR imaging of perianal fistulas. Am J Roentgenol. 1996;167:735–41.

    Article  CAS  Google Scholar 

  15. Buchanan GN, Williams AB, Bartram CI, Halligan S, Nicholls RJ, Cohen CRG. Potential clinical implications of direction of a trans-sphincteric anal fistula track. Br J Surg. 2003;90:1250–5.

    Article  CAS  PubMed  Google Scholar 

  16. Koelbel G, Schmiedl U, Majer MC, et al. Diagnosis of fistulae and sinus tracts in patients with Crohn disease: value of MR imaging. Am J Roentgenol. 1989;152:999–1003.

    Article  CAS  Google Scholar 

  17. Spencer JA, Chapple K, Wilson D, Ward J, Windsor AC, Ambrose NS. Outcome after surgery for perianal fistula: predictive value of MR imaging. Am J Roentgenol. 1998;171:403–6.

    Article  CAS  Google Scholar 

  18. Schwartz DA, Wiersema MJ, Dudiak KM, et al. A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn’s perianal fistulas. Gastroenterology. 2001;121:1064–72.

    Article  CAS  PubMed  Google Scholar 

  19. Taylor SA, Halligan S, Bartram CI. Pilonidal sinus disease: MR imaging distinction from fistula in ano. Radiology. 2003;226:662–7.

    Article  PubMed  Google Scholar 

  20. Schwartz DA, Loftus Jr EV, Tremaine WJ, et al. The natural history of fistulizing Crohn’s disease in Olmsted County, Minnesota. Gastroenterology. 2002;122:875–80.

    Article  PubMed  Google Scholar 

  21. Buchanan GN, Halligan S, Williams AB, Cohen RCG, Tarroni D, Phillips RKS, Bartram CI. Magnetic resonance imaging for primary fistula in ano. Br J Surg. 2003;90:877–81.

    Article  CAS  PubMed  Google Scholar 

  22. Bell SJ, Halligan S, Windsor ACJ, Williams AB, Wiesel P, Kamm A. Response of fistulating Crohn’s disease to infliximab treatment assessed by magnetic resonance imaging. Aliment Pharmacol Ther. 2003;17:387–93.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. UCL, Centre for Medical Imaging, University College Hospital, University College London, 235 Euston Road, London, NW1 2BU, UK

    Steve Halligan MBBS, MD, FRCR, FRCP & Stuart A. Taylor MBBS, BSc, MD, MRCP, FRCR

Authors
  1. Steve Halligan MBBS, MD, FRCR, FRCP
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stuart A. Taylor MBBS, BSc, MD, MRCP, FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steve Halligan MBBS, MD, FRCR, FRCP .

Editor information

Editors and Affiliations

  1. Department of GI Surgery, University College London Hospitals, London, United Kingdom

    Richard Cohen

  2. Department of GI Surgery, University College London Hospitals, London, United Kingdom

    Alastair Windsor

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Halligan, S., Taylor, S.A. (2014). Imaging of Anal Sepsis. In: Cohen, R., Windsor, A. (eds) Anus. Springer, London. https://doi.org/10.1007/978-1-84882-091-3_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-091-3_18

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-090-6

  • Online ISBN: 978-1-84882-091-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation