Digital Rectal Examination versus Magnetic Resonance Fistulography in Diagnosis of Perianal Fistula

Abstract

Introduction: Fistula in ano disease has significant implications for the patient’s quality of life as a sequelaerange from minor pain and social hygienic embarrassment to frank sepsis. The majority of fistula in ano has asingle simple track that is easily identified through PR examination and during surgery, however 5%-15% of caseshave more complicated course, with high recurrence rate due to errors in assessing and dealing with the internalopenings, the primary tract, or any secondary extensions and abscesses, particularly supralevator sepsis. Althoughmost fistulae are simple and easy to treat, some pose greater problems. Fear of causing incontinence and lack ofconfidence in fistula assessment prompt most referrals from other surgeons.Aim of work: To compare digital rectal examination and Magnetic Resonance Fistulography findings in diagnosisof perianal fistula and its type according to parks classification depending on intraoperative findings.Patients and methods: This is a Cross-sectional study (Diagnostic accuracy testing) was done on 30 patientspresented to outpatient clinic at El Demerdash hospital and Dar Elshefaa hospital examined and diagnosed withperianal fistula by colorectal consultants and had done Magnetic Resonance Fistulography.Results: This study’s results showed that there is no preference between preoperative examination findings andMRI findings in the determination of the type of tract of fistula in ano; however, there’s a significant preference forpreoperative examination over MRI findings in the detection of external and internal openings.Conclusion: There is no preference between preoperative examination of a fistula in ano by experienced colorectalconsultants and MRI findings in the determination of fistula type, while preoperative examination has a greaterpreference in the detection of external and internal openings over MRI findings.