[Usefulness of anal endosonography in the assessment of fistula-in-ano].
OBJECTIVE
The purpose of the present study was to define the diagnostic value of anal endosonography in the diagnostic work-up of fistula-in-ano.


METHODS
A retrospective study was carried out on 191 consecutive patients (m: 121; f: 70; mean age: 44.0 +/- 12.5 years; range: 0.5-77 years) who were diagnosed to suffer from fistula-in-ano by performing anal endosonography in an outpatient setting. All images were obtained with a Combison 310A ultrasound scanner (Kretz GmbH, Zipf, Osterreich) and 5-Mhz and 7.5-MHz transducer. 131 patients underwent surgery. According to the endosonographic findings fistulas were classified as transsphincteric in 44 %, intersphincteric in 22 %, subanodermal in 16 %, anovaginal in 8 %, suprasphincteric in 5 %, extrasphincteric in 1 % and others in 4 %.


RESULTS
In 125 patients (95 %) the preoperative diagnosis was confirmed intraoperatively. This cohort included 12 patients with a complex fistula system. In only 6 patients the preoperative ultrasound finding was misinterpreted.


CONCLUSIONS
In conclusion this study has shown that anal endosonography is a useful and reliable tool in the preoperative evaluation of uncomplicated and complicated anorectal fistulas.
Chirurgische Universitätsklinik Würzburg. busse@mail.uni-wuerzburg.de
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Bussen
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Sailer
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Wening
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Fuchs
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Thiede
D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019160:Endosonography; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012003:Rectal Fistula / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed