[Transperineal sonography in anorectal disorders]

Area of Science:

• Radiology
• Gastroenterology
• Surgical Oncology

Background:

• Conventional imaging methods like MRI, CT, and endosonography have limitations in diagnosing lower rectal, anal, and perianal conditions.
• Pain can hinder digital examination and limit the effectiveness of other diagnostic procedures.
• Transperineal sonography is established for pediatric anorectal malformations and prostate disease, but its adult application is less reported.

Purpose of the Study:

• To evaluate the utility of transperineal sonography in diagnosing lower rectal, anal, and perianal pathologies in adults.
• To assess the accuracy and feasibility of transperineal sonography as a diagnostic tool in this region.
• To compare transperineal sonography findings with intraoperative diagnoses.

Main Methods:

• A total of 44 adult patients underwent transperineal sonography (B-mode and color Doppler) between 1997 and 2000.
• Utilized 3.5 MHz sector and 7 MHz linear array transducers for imaging anorectal structures.
• Patient positioning on the side with anatomical landmarks (pubic symphysis, prostate, vagina) for orientation.

Main Results:

• Diagnosed a spectrum of conditions including perianal fistulas, abscesses, rectal/anal carcinomas, and metastasis.
• Transperineal sonography was crucial in 10 cases where intense pain precluded digital examination.
• Sonographic findings were confirmed intraoperatively in 85% (34/44) of patients.

Conclusions:

• Transperineal sonography is a cost-effective and readily available diagnostic modality.
• It effectively aids in detecting diverse pathological conditions of the lower rectum, anus, and perianal region.
• This technique offers a valuable alternative, particularly when other examination methods are limited.