Hallazgos ecográficos en la proctalgia espontánea y postoperatoria / No disponible

Objetivo: valorar la utilidad de la ecografía endoanal comoprueba de imagen para identificar la causa del dolor anal en lospacientes que presentan proctalgia idiopática o dolor postoperatorioy analizar cuáles son sus causas más frecuentes.Métodos: se realiza un estudio descriptivo de los hallazgos encontradosen las ecografías endoanales de pacientes con doloranal en los últimos seis años. Todas las ecografías se llevaron acabo con un ecógrafo B&K (Cheetah 2003, B&K Medical, Gentofte,Denmark) con sonda endoanal de 7 MHz.Resultados: se estudiaron noventa y cinco casos de proctalgiamediante ecografía endoanal. Sesenta y siete correspondieron a pacientescon una cirugía previa perineal o pélvica tras la cual comenzóel dolor anal: 48 habían sido intervenidos de fisura anal, 12 dehemorroidectomía, 4 de episiotomía, 2 de fístula y 1 de prostatectomía.El hallazgo más frecuente tras la cirugía de fisura anal fue lapresencia de una esfinterotomía incompleta. Entre los veintiochopacientes sin cirugía previa, el 57,14% presentaba hipertrofia delesfínter anal interno como única alteración ecográfica.Conclusiones: los pacientes con proctalgia espontánea ypostoperatoria pueden ser estudiados mediante ecografía endoanalya que el uso de la sonda no impide completar la exploración.Con esta prueba se encontró una causa del dolor en el 81,93% delos casos. La hipertrofia del esfínter anal interno aislada es el hallazgoecográfico más frecuente asociado a proctalgia espontánea

Objective: to assess the use of endoanal ultrasounds to identifyanal pain etiology in patients with either spontaneous or postoperativepain, and to review the most frequent causes.Methods: a descriptive study of ultrasound findings in patientswith anal pain during the last six years was performed. All ultrasoundscans were performed using a B&K Diagnostic UltrasoundSystem (Cheetah 2003, B&K Medical, Gentofte, Denmark) with a7-MHz endoprobe providing 360º images.Results: ninety-five cases of anal pain were studied by endoanalultrasonography. Sixty-seven cases of anal pain ocurred inpatients with previous perineal or pelvic surgery: anal fissure (48),hemorrhoidectomy (12), episiotomy (4), fistula (2), and prostatectomy(1). After fissure surgery, incomplete sphincterotomy wasthe first cause of anal pain. Twenty-eight patients had no previoussurgery, and more than 57.14% of them were found to have internalanal sphincter hypertrophy.Conclusions: patients with anal pain can be studied by endoanalultrasounds in spite of the use of an endoprobe. With thisexploration a cause of pain is found in 81.93% of cases. Internalanal sphincter hypertrophy is the most frequent finding associatedwith spontaneous anal pain

[Ultrasound findings in spontaneous and postoperative anal pain]. / Hallazgos ecográficos en la proctalgia espontánea u postoperatoria.

OBJECTIVE: To assess the use of endoanal ultrasounds to identify anal pain etiology in patients with either spontaneous or post-operative pain, and to review the most frequent causes. METHODS: A descriptive study of ultrasound findings in patients with anal pain during the last six years was performed. All ultrasound scans were performed using a B&K Diagnostic Ultrasound System (Cheetah 2003, B&K Medical, Gentofte, Denmark) with a 7-MHz endoprobe providing 360 degrees images. RESULTS: Ninety-five cases of anal pain were studied by endoanal ultrasonography. Sixty-seven cases of anal pain ocurred in patients with previous perineal or pelvic surgery: anal fissure (48), Hemorrhoidectomy (12), episiotomy (4), fistula (2), and prostatectomy (1). After fissure surgery, incomplete sphincterotomy was the first cause of anal pain. Twenty-eight patients had no previous surgery, and more than 57.14% of them were found to have internal anal sphincter hypertrophy. CONCLUSIONS: Patients with anal pain can be studied by endoanal ultrasounds in spite of the use of an endoprobe. With this exploration a cause of pain is found in 81.93% of cases. Internal anal sphincter hypertrophy is the most frequent finding associated with spontaneous anal pain.