ABSTRACT
BACKGROUND: anorectal ultrasonography (ARU) is a simple technique, and its diagnostic value for anorectal diseases either in conventional subjects or in patients with Crohn s disease (CD) is insufficiently reported. The objective of this study is to evaluate the use of ARU, its consistency with clinical orientation, and its ability to provide relevant information for patients with bowel CD and perianal involvement. METHODS: thirty ARUs were performed for 24 patients (17 male, mean age 35,7 years; range 19-59 years) with diagnosed CD (bowel and anorectal involvement). The reason to perform an ARU was to evaluate an anal fistula (15 patients, 50%), potential abscesses (9 patients, 30%), and fecal incontinence (2 patients, 6,6%), and for post-treatment monitoring purposes (4 patients, 13,3%). RESULTS: diagnostic orientation coincided for 14 patients (46,6%). An abscess was found in eight patients (26,6%), and five patients were clinically suspicious. The abscess was postanal in 3 patients. Fistulas were found in 17 patients (56,6%), and 15 patients were clinically suspicious. Transsphincterian fistulas were observed in seven patients, and abscesses were associated with fistula in six patients. Transsphincteric defects were observed in 10 patients (four internal sphincters, one external sphincter, and five both) but only two patients suffered from incontinence. ARU provided data relevant to therapeutic approach in 19 patients (63,3%). CONCLUSIONS: ARU has provided very important data for the diagnosis and treatment of anorectal diseases. Based on this technique clinical decisions can be improved, which in some instances may prove critical.
Subject(s)
Abscess/diagnostic imaging , Crohn Disease/diagnostic imaging , Endosonography , Rectal Fistula/diagnostic imaging , Abscess/etiology , Adult , Anal Canal/diagnostic imaging , Anal Canal/pathology , Crohn Disease/complications , Female , Humans , Male , Middle Aged , Rectal Fistula/etiologyABSTRACT
Introducción: la ecografía anorrectal (EAR) es una exploraciónsencilla y está altamente contrastado su utililización en la bibliografía.El propósito del estudio ha sido examinar la utilidad dela EAR, la coincidencia con la orientación clínica y la capacidadde aportación de datos de interés en aquellos pacientes con enfermedadde Crohn perianal (ECPA).Métodos: se realizaron 30 EAR en 24 pacientes (17 hombres,edad media 35,7) con enfermedad de Crohn diagnosticada ysospecha clínica de tener algún proceso anorrectal. El motivo másfrecuente de petición de EAR fue la valoración de fístula anal (15casos, 50%), sospecha abscesos (9 casos, 30%), incontinencia fecal(2 casos, 6,6%) y control evolutivo tras tratamiento (4 casos,13,3%).Resultados: la orientación diagnóstica coincidió en 14 pacientes(46,6%). Los abscesos fueron encontrados en 8 pacientes(26,6%), cinco de ellos sospechados clínicamente. La localizaciónmás frecuente fue postanal (3 pacientes). Se detectaron fístulas en17 pacientes (56,6%), en 15 de ellos sospechados; siendo la tranesfinterianala más frecuente (7 pacientes). En 6 pacientes las fístulastenían además abscesos asociados. Defectos esfinterianosfueron observados en 10 pacientes (cuatros del esfínter interno,uno del externo y cinco en ambos); sin embargo sólo 2 pacientespadecían incontinencia. Datos ultrasonográficos relevantes paraplantear un plan terapéutico fueron obtenidos en 19 pacientes(63,3%).Conclusiones: la EAR ha proporcionado importantes datosen el diagnóstico y para el tratamiento la enfermedad anorrectal.Basándonos en ella, podemos mejorar la decisión clínica, aportandoun cambio terapéutico que puede ser crítico en algunos casos
Background: anorectal ultrasonography (ARU) is a simpletechnique, and its diagnostic value for anorectal diseases either inconventional subjects or in patients with Crohn's disease (CD) isinsufficiently reported. The objective of this study is to evaluatethe use of ARU, its consistency with clinical orientation, and itsability to provide relevant information for patients with bowel CDand perianal involvement.Methods: thirty ARUs were performed for 24 patients (17male, mean age 35,7 years; range 19-59 years) with diagnosedCD (bowel and anorectal involvement). The reason to perform anARU was to evaluate an anal fistula (15 patients, 50%), potentialabscesses (9 patients, 30%), and fecal incontinence (2 patients,6,6%), and for post-treatment monitoring purposes (4 patients,13,3%).Results: diagnostic orientation coincided for 14 patients(46,6%). An abscess was found in eight patients (26,6%), andfive patients were clinically suspicious. The abscess was postanalin 3 patients. Fistulas were found in 17 patients (56,6%), and15 patients were clinically suspicious. Transsphincterian fistulaswere observed in seven patients, and abscesses were associatedwith fistula in six patients. Transsphincteric defects were observedin 10 patients (four internal sphincters, one externalsphincter, and five both) but only two patients suffered from incontinence.ARU provided data relevant to therapeutic approachin 19 patients (63,3%).Conclusions: ARU has provided very important data for thediagnosis and treatment of anorectal diseases. Based on this techniqueclinical decisions can be improved, which in some instancesmay prove critical
