The Usefulness of Endoanal Endoscopic Ultrasound in Anal Disease

Introduction: Anal disease encompasses various disorders including sphincter defects, anorectal fistulas and abscesses, unexplained chronic anal pain, and anal cancers. The aim of this study is to evaluate the diagnostic contribution of endoscopic ultrasound (EUS) in anal disease.

Materials and Methods: 56 patients underwent radial EUS examination, from March 2015 to March 2022.No sedation was needed for EUS examination. All EUS were performed using a flexible radial EUS probe with or without a linear probe and an ultrasound processor.

Results: Mean age was 42,4 years, 71,42% were female. The main clinical indication of anal EUS was the evaluation of anorectal suppuration, fecal incontinence (FI) and perineal crohn disease (CD). Anorectal suppurations were identified in 35,71% of cases. In patients with perineal CD, fistulas were found in 46.15% of CD cases. Anovaginal or rectovaginal fistulas (ARVFs) unrelated to CD were visualized in 8.93% of all cases. In patients presenting with FI, EUS identified internal and external anal sphincter defects.

Conclusion: EUS is a sensitive technique in the evaluation of anal anatomy and the diagnosis of benign and malignant anal disease.