Usefulness of hydrogen peroxide enhancement in diagnosis of anal and ano-vaginal fistulas |
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Authors: | Sudol-Szopińska Iwona Jakubowski Wieslaw Szczepkowski Marek Sarti Dariusz |
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Institution: | (1) Imaging Diagnostics Department, Second Medical Faculty, Medical Academy, Warsaw, Poland,;(2) Zakład Diagnostyki Obrazowej II Wydz. Lekarski AM w Warszawie, Wojewódzki Szpital Bródnowski, ul. Kondratowicza 8, 03–285 Warsaw, Poland,;(3) Second Surgical Department, Bielany Hospital, 01–809 Warsaw, Poland,;(4) Department of Proctology, Warsaw County Hospital, 02–001 Warsaw, Poland, |
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Abstract: | Our objective was to assess if contrast-enhanced (CE) anal endosonography (AES) with hydrogen peroxide is useful in the diagnosis
of anal and ano-vaginal fistulas. A Bruel and Kjaer scanner with a 7.0-MHz transducer was used. After visualization of the
fistula tract in non-contrast (NC) AES, hydrogen peroxide was introduced into the fistula tract through the external opening
in 22 patients with different types of anal fistulas. Both CE and NC AES revealed 13 transsphincteric, 3 intersphincteric,
2 suprasphincteric and 4 ano-vaginal fistulas. Simple tracts were found in 16 cases and complex in 6 cases in non-contrast
AES. The CE AES revealed 19 simple and 3 complex fistulas. Fifteen internal openings visible in NC AES were confirmed in CE
AES in 6 cases, which additionally found 11 more internal openings. Surgery confirmed all types of fistulas found in NC and
CE AES; however, the latter two found 18 simple and 4 complex fistulas, and 21 internal openings. Both NC and CE AES are able
to correctly differentiate types of anal fistulas and are of comparable value in differentiating simple from complex fistulas,
although a false-negative result was found in CE AES. In the preoperative assessment of the internal opening, CE AES is superior
to NC AES.
Electronic Publication |
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Keywords: | Anal endosonography Anal fistula |
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