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.
⁎Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
‡Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands
Reprint requests Address requests for reprints to: Jaap Stoker, MD, Department of Radiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. fax: (31) 20-566-9119
Conflicts of interest The authors disclose no conflicts.
ABSTRACT