Digital Rectal Examination versus Magnetic Resonance Fistulography in Diagnosis of Perianal Fistula

Document Type : Original Article

Authors

General Surgery Department, Faculty of Medicine, Ain Shams University, Egypt

Abstract

Introduction: Fistula in ano disease has significant implications for the patient’s quality of life as a sequelae
range from minor pain and social hygienic embarrassment to frank sepsis. The majority of fistula in ano has a
single simple track that is easily identified through PR examination and during surgery, however 5%-15% of cases
have more complicated course, with high recurrence rate due to errors in assessing and dealing with the internal
openings, the primary tract, or any secondary extensions and abscesses, particularly supralevator sepsis. Although
most fistulae are simple and easy to treat, some pose greater problems. Fear of causing incontinence and lack of
confidence in fistula assessment prompt most referrals from other surgeons.
Aim of work: To compare digital rectal examination and Magnetic Resonance Fistulography findings in diagnosis
of perianal fistula and its type according to parks classification depending on intraoperative findings.
Patients and methods: This is a Cross-sectional study (Diagnostic accuracy testing) was done on 30 patients
presented to outpatient clinic at El Demerdash hospital and Dar Elshefaa hospital examined and diagnosed with
perianal fistula by colorectal consultants and had done Magnetic Resonance Fistulography.
Results: This study’s results showed that there is no preference between preoperative examination findings and
MRI findings in the determination of the type of tract of fistula in ano; however, there’s a significant preference for
preoperative examination over MRI findings in the detection of external and internal openings.
Conclusion: There is no preference between preoperative examination of a fistula in ano by experienced colorectal
consultants and MRI findings in the determination of fistula type, while preoperative examination has a greater
preference in the detection of external and internal openings over MRI findings.

Keywords

Ain Shams Journal of Surgery
Volume 17, Issue 1
January 2024
Pages 71-75

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