Piccinini E E, Rosati G, Ugolini G, Marroccu S, Del Governatore M, Conti A
Policlinico Sant'Orsola, Istituto di Clinica Chirurgica III, Università degli Studi, Bologna.
Minerva Chir. 1996 Sep;51(9):653-9.
The fistulous tracks and abscesses may be related anatomically to the anal sphincters and levator ani muscles. Defining the anatomical relationship between the fistulous lesion and the anal sphincters and/or adjacent organs is essential for correct management. Clinical examination can suggest possible sepsis or the direction of the fistulous track. We report the results of anal endosonography in the evaluation of 54 patients affected by perianal sepsis and fistula in ano. Anal endosonography has correctly identified 22 of 22 internal openings seen at the surgery, 14 of 16 intersphincteric tracts while only 7 of the 9 trans-sphincteric tracks described by anal endosonography were present at the surgery. All the abscesses were correctly identified. Anal endosonography provides a high-resolution image of the anatomy of anal canal and defines the anatomy of tracks and abscesses in relation to the sphincters, determines if there has been trans-sphincteric extension of the sepsis and assesses the state of the sphincters. We have observed a good correlation between the preoperative AES findings and those at surgery. We conclude that anal endosonography is a useful diagnostic procedure in patients with perianal sepsis.
肛瘘管和脓肿在解剖学上可能与肛门括约肌和肛提肌相关。明确肛瘘病变与肛门括约肌和/或相邻器官之间的解剖关系对于正确的治疗至关重要。临床检查可提示可能的脓毒症或肛瘘管的走向。我们报告了肛门内超声检查对54例肛周脓毒症和肛管肛瘘患者的评估结果。肛门内超声检查正确识别出手术中所见的22个内口中的22个，16个括约肌间瘘管中的14个，而肛门内超声检查描述的9个经括约肌瘘管中只有7个在手术中存在。所有脓肿均被正确识别。肛门内超声检查提供了肛管解剖结构的高分辨率图像，明确了瘘管和脓肿与括约肌相关的解剖结构，确定脓毒症是否有经括约肌扩展，并评估括约肌的状态。我们观察到术前肛门内超声检查结果与手术结果之间有良好的相关性。我们得出结论，肛门内超声检查对于肛周脓毒症患者是一种有用的诊断方法。
