Event Title

USE OF ENDOANAL ULTRASOUND IN ANORECTAL DISEASES: OUR CLINICAL EXPERIENCE

Session

Medicine and Nursing

Description

INTRODUCTION: Benign anorectal diseases are very common in the general population. Fistula-in-ano obstructed defecation, and fecal incontinence remains a major challenge in surgery. The high rate of surgical failures and the need for repetitive surgical interventions are common experiences for physicians dealing with these pathologies. Endoanal ultrasound is now regarded as the gold standard for evaluating anal sphincter pathology in the investigation of anal incontinence. Endocavitary ultrasound for anal and rectal pathologies was first used in the early 60s for the initial assessment of rectal tumors. The main indications of the endoanal ultrasound are the assessment of anal fistula and the anal sphincter study in patients with fecal incontinence. Endorectal ultrasound is widely used in rectal cancer staging.

AIM: The purpose of this paper is to present the results of our work with endoanal ultrasound in our patients with benign and malignant anorectal diseases.

METHOD: The study included 65 patients [24 females (36.9%) and 41 males (63.1%), with a mean age of 49.29 ± 16.5 years, range 14-84], with benign and malignant anorectal diseases, who were registered at the “Gastromed - AFM” Ordinance in Pristina during the period March 2018 - January 2020. After taking the history, physical examination, and endoscopy, an endoanal/transrectal ultrasound was performed with a Hitachi EUP-R54AW-19 probe.

RESULTS: Based on the indications for endosonographic examination, patients were divided into 5 groups: with anal pain [n = 31 (47.7%)], with fecal incontinence [n = 11 (16.9%)], rectal cancer [n = 4 (6.2%)], constipation [n = 10 (15.4%)], and with perianal fistulas [n = 9 (13.8%)]. As can be seen almost half (47.7%) of the patients were with anal pain. Ten patients had fistulas (out of 5 with intersphincteric and transfincteric fistulas). Endosonography had also revealed four abscesses. Sphincter damage was present in 11 patients (16.9%). The internal anal sphincter was mostly damaged in 8 (12.3%) patients, while the external one was damaged in one patient (1.5%). Both sphincters were damaged in both patients. The anal fissure was the most common cause of anal pain, 17 patients (26.2%).

CONCLUSIONS: Endoanal ultrasound is easy to apply, well accepted by the patient, requires simple preparation, is inexpensive, and provides accurate and rapid information on regional anatomy. All these features make endoanal ultrasound to be the method of choice in patients with anorectal diseases.

Keywords:

Kosovo, endoanal ultrasound, anal pain, fistula

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-550-47-5

Location

UBT Kampus, Lipjan

Start Date

30-10-2021 12:00 AM

End Date

30-10-2021 12:00 AM

DOI

10.33107/ubt-ic.2021.180

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Oct 30th, 12:00 AM Oct 30th, 12:00 AM

USE OF ENDOANAL ULTRASOUND IN ANORECTAL DISEASES: OUR CLINICAL EXPERIENCE

UBT Kampus, Lipjan

INTRODUCTION: Benign anorectal diseases are very common in the general population. Fistula-in-ano obstructed defecation, and fecal incontinence remains a major challenge in surgery. The high rate of surgical failures and the need for repetitive surgical interventions are common experiences for physicians dealing with these pathologies. Endoanal ultrasound is now regarded as the gold standard for evaluating anal sphincter pathology in the investigation of anal incontinence. Endocavitary ultrasound for anal and rectal pathologies was first used in the early 60s for the initial assessment of rectal tumors. The main indications of the endoanal ultrasound are the assessment of anal fistula and the anal sphincter study in patients with fecal incontinence. Endorectal ultrasound is widely used in rectal cancer staging.

AIM: The purpose of this paper is to present the results of our work with endoanal ultrasound in our patients with benign and malignant anorectal diseases.

METHOD: The study included 65 patients [24 females (36.9%) and 41 males (63.1%), with a mean age of 49.29 ± 16.5 years, range 14-84], with benign and malignant anorectal diseases, who were registered at the “Gastromed - AFM” Ordinance in Pristina during the period March 2018 - January 2020. After taking the history, physical examination, and endoscopy, an endoanal/transrectal ultrasound was performed with a Hitachi EUP-R54AW-19 probe.

RESULTS: Based on the indications for endosonographic examination, patients were divided into 5 groups: with anal pain [n = 31 (47.7%)], with fecal incontinence [n = 11 (16.9%)], rectal cancer [n = 4 (6.2%)], constipation [n = 10 (15.4%)], and with perianal fistulas [n = 9 (13.8%)]. As can be seen almost half (47.7%) of the patients were with anal pain. Ten patients had fistulas (out of 5 with intersphincteric and transfincteric fistulas). Endosonography had also revealed four abscesses. Sphincter damage was present in 11 patients (16.9%). The internal anal sphincter was mostly damaged in 8 (12.3%) patients, while the external one was damaged in one patient (1.5%). Both sphincters were damaged in both patients. The anal fissure was the most common cause of anal pain, 17 patients (26.2%).

CONCLUSIONS: Endoanal ultrasound is easy to apply, well accepted by the patient, requires simple preparation, is inexpensive, and provides accurate and rapid information on regional anatomy. All these features make endoanal ultrasound to be the method of choice in patients with anorectal diseases.