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目的 了解经肛门超声内镜检查对内口已经愈合的肛瘘病人内口部位的诊断价值。方法 对临床常规手术未能发现肛瘘内口的12例病人进行超声内镜检查，并进行手术治疗。分析经肛门超声内镜检查对内口已经愈合的肛瘘病人内口部位的诊断价值和超声影像学特点，并与其它常规检查方法比较。结果 内镜超声检查在12例病 人均发现已经愈合的内口的准确位置，准确性优于Goodsall规律、肛门直肠肛门指诊、窦道造影或美蓝注射以及窦道探针探查。结论 经肛瘘外口位置注射美蓝，可方便手术医师快速定位内口。经肛门超声内镜检查是定位已经愈合的肛瘘内口的准确、快速、简单、耐受性好的检查手段。在超声内镜发现内口后，经内镜在内口位置注射美蓝，可方便手术医师快速定位内口。

Diagnostic value of anal endosonography in revealing healed internal opening in fistula-in -ano.

Objective To define the value of anal endosonography in revealing healed internal opening in patients with fistula-in-ano.Methods 12 patients with fistula-in-ano in whom the healed internal openings could not be located by routine methods received anal endosonographic examinations and operations.Endosonographic characteristics and its diagnostic value were analyzed and compared with other routine methods.Results Endosonography revealed internal openings in all 12 patients,and was more accurate and sensitive than other methods,such as Goodsall rule,digital examination,fistula injection of methylene blue,fistula imaging and fistula probing.We found that after the interanl opening was identified under endosonography,it is a good way to inject methyline blue in the site of internal opening as a mark for surgeon to identify the internal opening during operation.Conclusion Anal endosonography is an accruate,rapid,simple,and well-tolerated technique.Injection of methylene blue in the site of internal opening would make it easier for surgeon to indentify the internal opening.