[Contrast-enhanced endoanal and transanal sonography for perianal fistulas].

AIM: Perineal and endorectal sonographic investigation before and after the contrast enhancement with hydrogen peroxide for patients with fistule pathology has been perfomed aimed at the development of the perianal fistules diagnostics.

MATERIAL AND

METHODS

Five patients (4 men and 1 woman) with perianal fistulas have been tested. Four of them are operated. The only woman in the group is with the active illness of Crohn. After the native (without contrast) transperineal and endoanal sonographies, hydrogen peroxide has been insuflated in the fistulas and the sonographic tests have been repeated.

RESULTS

All fistulas have been identified by native endoanal and transperineal sonographies. The contrast application additionally specifies the fistula location and its connection with the anal lumen. For the tested patients the fistulas are as follows: intersphincteric - for 2 patients, transsphincteric - for 2 and suprasphincteric complicated (with 2 ducts) fistula - for 1 patients. The sonographic tests findings have been conformed intraoperatively. Hypervascularization in the wall has been established by Doppler technique for 3 of patients. For 2 of them both arterial and vine blood streams are registered, while for the third of them - only arterial blood stream is observed.

CONCLUSION

The joint application of the endoanal and transperineal sonographies, combined with the possibilities of the Doppler technique and the hydrogen peroxide contrast enhancement is represents and effective method of finding and anatomotopographic localization specification of the perianal fistulas.