Diagnosis of Anorectal Disease

  • Pasquale Ialongo
  • Loredana Adami
  • Maurizio Atzori
  • Cesare Hassan
  • Andrea Cortese
  • Giovanni Regine
Part of the Updates in Surgery book series (UPDATESSURG)


One-third of patients affected by chronic inflammatory bowel diseases (IBDs) also suffer from fistulas of different sizes and types. The majority of fistulous tracts are identified in the anal rectal area, with chronic inflammation, and in the surrounding perivisceral adipose tissues [1]. Diagnostic imaging aims to identify and depict the complex fistulous tracts that can appear at the top of the anal canal as well as the potential involvement of the anal sphincter and the extension of the fistula to the ischioanal fossa.


Rectovaginal Fistula Fistulous Tract Perianal Fistula Ischiorectal Fossa Anorectal Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Schwartz DA, Loftus EV Jr, Romaine WJ et al. (2002) The natural history of fistulizing Crohn’s disease in Olmsted County, Minnesota. Gastroenterology 122(4):875–880CrossRefPubMedGoogle Scholar
  2. 2.
    Kuijpers HC, Schulpen T (1985) Fistulography for fistula-in-ano: is it useful? Dis Colon Rectum 28:103–104CrossRefPubMedGoogle Scholar
  3. 3.
    Choen S, Burnett S, Bartram CI, Nicholls RJ (1991) Comparison between anal endosonography and digital examination in the evaluation of anal fistulae. Br J Surg 78:445–447CrossRefPubMedGoogle Scholar
  4. 4.
    Morris J, Spencer JA, Ambrose NS (2000) MR imaging classification of perianal fistulas and its implications for patient management. Radio Graphics 20:623–635Google Scholar
  5. 5.
    Yousem DM, Fishman EK, Jones B (1988) Crohn disease: perirectal and perianal findings at CT. Radiology 167:331–334PubMedGoogle Scholar
  6. 6.
    Spencer JA, Ward J, Beckingham IJ et al (1996) Dynamic contrast-enhanced MR imaging of perianal fistulas. AJR Am J Roentgenol 167:735–741PubMedGoogle Scholar
  7. 7.
    deSouza NM, Gilderdale DJ, Coutts GA et al (1998) MRI of fistula-in-ano: a comparison of endoanal coil with external phased array coil techniques. J Comput Assist Tomogr 22:357–363CrossRefPubMedGoogle Scholar
  8. 8.
    Stoker J, Rociu E, Schouten WR, Lameris JS (2002) Anovaginal and rectovaginal fistulas: endoluminal sonography versus endoluminal MR imaging. AJR Am J Roentgenol 178:737–741PubMedGoogle Scholar
  9. 9.
    Maier AG, Funovics MA, Kreuzer SH et al (2001) Evaluation of perianal sepsis: comparison of anal endosonography and magnetic resonance imaging. J Magn Reson Imaging 14:254–260CrossRefPubMedGoogle Scholar
  10. 10.
    Halligan S, Bartram CI (1998) MR imaging of fistula in ano: are endoanal coils the gold standard? AJR Am J Roentgenol 171:407–412PubMedGoogle Scholar
  11. 11.
    Spencer JA, Ward J, Beckingham IJ et al (1996) Dynamic contrast-enhanced MR imaging of perianal fistulas. AJR Am J Roentgenol 167(3):735–741PubMedGoogle Scholar
  12. 12.
    Stoker J, Jong Tjien Fa VE, Eijkemans MJ et al (1998) Endoanal MR imaging of perianal fistulas: the optimal imaging planes. Eur Radiol 8:1212–1216CrossRefPubMedGoogle Scholar
  13. 13.
    Parks AG, Gordon PH, Hardcastle JD (1976) A classification of fistula-in-ano. Br J Surg 63:1–12CrossRefPubMedGoogle Scholar
  14. 14.
    Hallingan S, Stoker J (2006) Imaging of fistula in ano. Radiology 239:18–33CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2010

Authors and Affiliations

  • Pasquale Ialongo
    • 1
  • Loredana Adami
    • 1
  • Maurizio Atzori
    • 1
  • Cesare Hassan
    • 2
  • Andrea Cortese
    • 1
  • Giovanni Regine
    • 1
  1. 1.Department of RadiologySan Camillo-Forlanini HospitalRomeItaly
  2. 2.Gastroenterology UnitRegina Margherita HospitalRomeItaly

Personalised recommendations