Abscess and fistula in the anorectal region can reabily be a source for infection spread to the adjacent compartments around the anorectal junction which is interconnected from muscularis propria of the rectal wall to the internal sphincter of
the
anal
canal. Prompt and yet accurate diagnosis will lead to optimal surgical management of the parient. To evaluate the diagnostic value of endorectal sonography, we reviewed operatively confirmed 18 cases. of anorectal abscess with or without fistulae
in 14
parients.
Abscesses were classified into the 5 types according to the location: ischiorectal, parianal, intersphincteric, submucous (intermuscular) type. The most frequent type was ischiorectal in 10 cases (55.6%) Perianal type was seen in 3 cases (16.6%),
intersphincteric in 2 cases (11.1%), supralevator in 2 cases (11.1%) and submucous type in 1 case (5.6%). The most frequent direction of the abscess spread was to the posterior aspect of the rectum in 9 cases (50%). Horseshoe shape abscess was
present
in 2 cases. Fistulae were classified into 4 types according to the relationship of the tracks to the internal and external sphincter; transsphincteric, intersphincteric, suprasphincteric, and extrasphincteric. Fistulous tracks were associated in
12
of
14 patients and the most common feature was transphincteric type in 8 cases(66.7%).
In conclusion the endorectal sonography is a useful method in evaluation of location, extent and detection of fistula in anorectal abscess.
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