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Radiol Clin North Am. 2003 Mar;41(2):443-57.

Imaging anal fistula.

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Department of Intestinal Imaging, Imperial College of London, Faculty of Medicine, London, United Kingdom.


The management of fistula-in-ano has been based on digital examination and operative findings. MR imaging has shown significant limitations to this approach, particularly in the management of recurrent fistula. The most cost-effective approach may be using a combination of endosonography and MR imaging. Preoperative confirmation of fistula complexity facilitates surgery planning of sphincter saving techniques and prevents sepsis being missed, which has been shown to reduce recurrence. Imaging has a significant role to play in this condition to improve patient outcome.

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