Graf D, Aeberhard P
Chirurgische Klinik, Kantonsspital Aarau.
Swiss Surg. 1995(6):294-7; discussion 297.
Endoluminal sonography was performed in 31 patients with suspected perianal or perirectal abscesses or fistulas. Patients with unequivocal clinical findings underwent surgical treatment without preceding sonography. The aim of the sonographical examination was to identify the abscesses, their topographical location, and the internal opening of the fistulas. These results were compared with operative findings. An abscess was diagnosed in 22 patients and could be confirmed by surgery in 21. In one patient a hypoechogenic scar resulting from previous surgery was erroneously interpreted as an intersphincteric abscess. The remaining 9 patients suffered from a fistula without abscess. In all 21 abscesses the sonographic examination showed the correct topographical location. There were 5 perianal, 8 intersphincteric and 8 ischiorectal abscesses. The operation demonstrated the internal opening of the fistula in 17 of 35 cases. Only 9 of these 17 openings (53%) had been identified by preoperative ultrasonography. The endoluminal sonography is a good method to find a perianal or perirectal abscess and to show the topographical location. It should be performed in all cases with an obscure preoperative clinical situation.
对31例疑似肛周或直肠周围脓肿或肛瘘的患者进行了腔内超声检查。临床诊断明确的患者未先行超声检查即接受了手术治疗。超声检查的目的是识别脓肿、其部位以及肛瘘的内口。将这些结果与手术所见进行比较。22例患者诊断为脓肿，其中21例经手术证实。1例患者因既往手术形成的低回声瘢痕被误诊为括约肌间脓肿。其余9例患者患有肛瘘但无脓肿。在所有21例脓肿中，超声检查均显示了正确的部位。其中肛周脓肿5例，括约肌间脓肿8例，坐骨直肠窝脓肿8例。手术发现35例中有17例存在肛瘘内口。术前超声检查仅识别出这17个内口中的9个（53%）。腔内超声是发现肛周或直肠周围脓肿并显示其部位的良好方法。所有术前临床情况不明的病例均应进行此项检查。
