The use of transperineal ultrasound and endosonography using H2O2 in the diagnosis of perianal abscesses and fistulas in children
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 8
Abstract
Introduction. Perianal abscesses are not uncommon pathology in children, while the ethiopathology of perianal fistula still need to be determined. Surgical treatment involves abscess incision and evacuation usually without the need for imaging. Transperineal ultrasound (TPUS) and endorectal ultrasound (ERUS) enable the assessment of the distribution and penetration of perianal abscesses and fistulas.Aim. Aim of this study is the evaluation of usefulness of the intrasurgical TPUS and H2O2 enhanced endosonography in the assessment of the distribution and penetration of perianal abscesses and fistulas in children.Material and methods. US examination was performed in 9 children (aged 2 month to 8 years old) with perianal abscess and fistula. The examination was performed before abscess incision in order to assess its distribution, as well as after surgical incision, and H2O2 injection to visualise fistulous tract. The US examinations were performed with the use of Philips iU22 ultrasound scanner with high frequency transducers (L 12-5 MHz and L 15-7 MHz) and BK-Medical Profocus ultrasound scanner with high frequency (16-9 MHz) 360 degrees rotational transducer with automatic 3D data acquisition (type 2050).Results. The measurements of perianal abscesses and fistulas in all patients taken at B-mode US were statistically significantly lower than that ones taken after H2O2 injection. H2O2 enhanced US examination enabled precise assessment of anatomical relations between abscesses and fistulous tracts towards external and internal anal sphincters influencing widening of the extent of surgery. Surgical treatment was successful in all patients. No recurrence was noticed in short time follow-up.Conclusions. Transperineal and transanal US with the use of high frequency transducers and H2O2 injection enabled precise assessment of the distribution of perianal abscesses and fistulas, and had an impact on the surgery extent.
Authors and Affiliations
Agnieszka Brodzisz, Czesław Cielecki, Paweł Nachulewicz
Keywords
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