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Clin Gastroenterol Hepatol. 2009 Oct;7(10):1037-45. doi: 10.1016/j.cgh.2009.06.030. Epub 2009 Jul 31.

Imaging of perianal fistulas.

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Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands.


Perianal fistulas, cryptoglandular or Crohn's disease-related, have a tendency to recur. Recurrence usually is owing to missed infection during surgery for cryptoglandular fistulas or insufficient response to medical treatment in Crohn's disease. It is now recognized that preoperative imaging (endoanal ultrasound and magnetic resonance imaging) can help to identify extensions that otherwise would be missed during surgery and therefore prevent recurrence. For medical therapy, the extent of the disease and the presence of abscesses are identified with imaging and therapy response can be monitored. The purpose of this review is to give an up-to-date overview of the anal anatomy, classification of perianal fistulas, and the role of imaging modalities in the management of patients with perianal fistulas.

[Indexed for MEDLINE]

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