Perianal fistulas
Written by:Perianal fistulas are a very unpleasant disorder that, if not diagnosed early, can become a serious problem. Dr. Marco Estienne, an expert in Radiology in Genoa, talks about it
What are perianal fistulas?
The fistula is a journey that starts from the abscess and makes its way to the skin near the anus (external orifice). If there is only one route, it is called a simple fistula, while if there are several routes, sometimes even distant from each other, it is called a complex fistula. Perianal fistulas are caused by a suppurative inflammatory process (abscess) that begins inside the anal canal, where small glands are present that can be infected by bacteria present in the rectal-anal tract.
What are the symptoms?
The abscess and perianal fistula manifest themselves with intense pain and burning in the anal region, often with a high fever; when the fistula opens outward, pus is released. Sometimes the external orifice of the fistula closes spontaneously, but the fistula usually does not heal and often tends to reform (recurrence).
How are they diagnosed?
For the assessment of an abscess and perianal fistula it is necessary to contact a proctologist specialist and to define the type of fistula and in order to identify the depth and the arrangement of the abscess, the course and the presence of any secondary fistulous tracts is possible perform two types of diagnostic tests: endoanal ultrasound and magnetic resonance.
The endoanal ultrasound
The endoanal ultrasound performed with a 360 ° rotating probe is the first-instance examination in abscesses and fistulas of early onset (simple fistulae); it is performed by inserting a dedicated probe into the anal canal without the need for preparation before the examination. The examination is well tolerated and lasting about 5-10 minutes, has a high diagnostic accuracy if carried out by dedicated professionals and experts with high quality equipment.
Magnetic resonance
In the case of complex or recurrent fistulas after surgical treatments, the most suitable examination is the magnetic resonance, which allows a wider view of the perianal and perirectal region and allows to better define the residues of active disease from the surgical outcomes. The examination is performed on high field devices, without inserting probes into the anal canal and preferably with contrast agent administration; the exam lasts about 15-20 minutes.
What are perianal fistulas?
The fistula is a journey that starts from the abscess and makes its way to the skin near the anus (external orifice). If there is only one route, it is called a simple fistula, while if there are several routes, sometimes even distant from each other, it is called a complex fistula. Perianal fistulas are caused by a suppurative inflammatory process (abscess) that begins inside the anal canal, where small glands are present that can be infected by bacteria present in the rectal-anal tract.
What are the symptoms?
The abscess and perianal fistula manifest themselves with intense pain and burning in the anal region, often with a high fever; when the fistula opens outward, pus is released. Sometimes the external orifice of the fistula closes spontaneously, but the fistula usually does not heal and often tends to reform (recurrence).
How are they diagnosed?
For the assessment of an abscess and perianal fistula it is necessary to contact a proctologist specialist and to define the type of fistula and in order to identify the depth and the arrangement of the abscess, the course and the presence of any secondary fistulous tracts is possible perform two types of diagnostic tests: endoanal ultrasound and magnetic resonance.
The endoanal ultrasound
The endoanal ultrasound performed with a 360 ° rotating probe is the first-instance examination in abscesses and fistulas of early onset (simple fistulae); it is performed by inserting a dedicated probe into the anal canal without the need for preparation before the examination. The examination is well tolerated and lasting about 5-10 minutes, has a high diagnostic accuracy if carried out by dedicated professionals and experts with high quality equipment.
Magnetic resonance
In the case of complex or recurrent fistulas after surgical treatments, the most suitable examination is the magnetic resonance, which allows a wider view of the perianal and perirectal region and allows to better define the residues of active disease from the surgical outcomes. The examination is performed on high field devices, without inserting probes into the anal canal and preferably with contrast agent administration; the exam lasts about 15-20 minutes.