[Importance of physical examination and imaging techniques in the diagnosis of anorectal fistulae].
OBJECTIVE
The study was designed to determine the role of clinical examination and imaging techniques in the diagnosis of anorectal fistula.


METHODS
We performed an observational study with prospective recruiting using the data of 120 patients, by means of clinical evaluation by an experienced coloproctologist surgeon (EE), a surgeon without special training in coloproctology (CE), and examination under anaesthesia (SE), endoanal ultrasound (EAU) and magnetic resonance (MR), using the surgical findings as a reference.


RESULTS
SE was significantly better than EE or CE for detecting an internal opening (IO), primary track and abscess cavities (AC). EAU was significantly more sensitive and accurate than the EE in identifying an IO, and AC, but not compared to the SE. MR was more sensitive than the EE in the identification of the IO, transphincter and suprasphincter tracks and AC with no significant differences compared to EAU, and more sensitive than the SE to detect AC.


CONCLUSIONS
Examination under anaesthesia still has a place in the evaluation of anorectal fistula. Imaging methods are an occasional complement to a clinical evaluation that can help the less experienced to decide the appropriate treatment, particularly when a complex fistula is suspected.
Jordán
Julio
J
Servicio de Cirugía General y Digestiva, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, España.
Roig
José V
JV
García Armengol
Juan
J
Esclapez
Pedro
P
Jordán
Yolanda
Y
García Granero
Eduardo
E
Alós
Rafael
R
Lledó
Salvador
S
D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011446:Prospective Studies; D012003:Rectal Fistula / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography