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Frequencies of perianal fistula types using two classification systems
Esra Ozkavukcu1, Nuray Haliloglu, Ayse Erden
1Radyoloji Bölümü, Ankara Üniversitesi Tıp Fakültesi Cebeci Hastanesi, Dikimevi, Ankara, Turkey. eozkavukcu@gmail.com
Japanese Journal of Radiology
|July 1, 2011
Summary
Transsphincteric and intersphincteric fistulas are most common. While the Parks and St. James
Area of Science:
- Proctology
- Gastroenterology
- Radiology
Background:
- Perianal fistulas are complex anorectal conditions requiring accurate classification for effective management.
- Existing classification systems, such as the Parks and St. James's University Hospital (SJUH) systems, are widely used but their adequacy is debated.
- Magnetic resonance imaging (MRI) is a key imaging modality for visualizing perianal fistula anatomy.
Purpose of the Study:
- To determine the frequencies of perianal fistula subtypes using the Parks and SJUH classification systems.
- To evaluate the adequacy of the Parks and SJUH classification systems in classifying and reporting perianal fistulas.
- To identify potential limitations in current classification methods.
Main Methods:
- Retrospective review of magnetic resonance imaging (MRI) examinations from 52 patients diagnosed with perianal fistula.
- Classification of perianal fistulas based on the Parks and SJUH classification systems.
- Analysis of the distribution of fistula subtypes within each classification system.
Main Results:
- The Parks system identified intersphincteric (25%), transsphincteric (69.23%), and extrasphincteric (3.84%) fistulas.
- The SJUH system classified fistulas into grade 1 (19.23%), grade 2 (3.84%), grade 3 (25%), grade 4 (40.38%), and grade 5 (9.61%).
- A small percentage of fistulas (1.92% subsphincteric) remained unclassified by both systems.
Conclusions:
- Transsphincteric and intersphincteric fistulas are the most prevalent subtypes.
- Both the Parks and SJUH classification systems are largely adequate for describing perianal fistulas.
- A small proportion of perianal fistulas present challenges for classification within these systems.
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