title: [Importance of physical examination and imaging techniques in the diagnosis of anorectal fistulae].
abstract: 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.
authors.affiliation: Servicio de Cirugía General y Digestiva, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, España.
authors.forename: Julio
authors.initials: J
authors.lastname: Jordán
authors.forename: José V
authors.initials: JV
authors.lastname: Roig
authors.forename: Juan
authors.initials: J
authors.lastname: García Armengol
authors.forename: Pedro
authors.initials: P
authors.lastname: Esclapez
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Jordán
authors.forename: Eduardo
authors.initials: E
authors.lastname: García Granero
authors.forename: Rafael
authors.initials: R
authors.lastname: Alós
authors.forename: Salvador
authors.initials: S
authors.lastname: Lledó
mesh_terms: 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