use of anorectal ultrasounds in perianal crohn's disease: consistency with clinical data utilidad de la ecografía anorrectal en el crohn perianal y su concordancia con la clínica

Background: anorectal ultrasonography (ARU) is a simple technique, and its diagnostic value for anorectal diseases either in conventional subjects or in patients with Crohn's disease (CD) is insufficiently reported. The objective of this study is to evaluate the use of ARU, its consistency with clinical orientation, and its ability to provide relevant information for patients with bowel CD and perianal involvement. Methods: thirty ARUs were performed for 24 patients (17 male, mean age 35,7 years; range 19-59 years) with diagnosed CD (bowel and anorectal involvement). The reason to perform an ARU was to evaluate an anal fistula (15 patients, 50%), potential abscesses (9 patients, 30%), and fecal incontinence (2 patients, 6,6%), and for post-treatment monitoring purposes (4 patients, 13,3%). Results: diagnostic orientation coincided for 14 patients (46,6%). An abscess was found in eight patients (26,6%), and five patients were clinically suspicious. The abscess was postanal in 3 patients. Fistulas were found in 17 patients (56,6%), and 15 patients were clinically suspicious. Transsphincterian fistulas were observed in seven patients, and abscesses were associated with fistula in six patients. Transsphincteric defects were observed in 10 patients (four internal sphincters, one external sphincter, and five both) but only two patients suffered from incontinence. ARU provided data relevant to therapeutic approach in 19 patients (63,3%). Conclusions: ARU has provided very important data for the diagnosis and treatment of anorectal diseases. Based on this technique clinical decisions can be improved, which in some instances may prove critical.