Hari Ram Jat1, Neel Patel2, Sitaram Barath3, Pooja Yadav4
BACKGROUND
Perianal fistulas account for a substantial discomfort and morbidity to the patient
thus affecting productive man hours and quality of life. Accurate pre-operative
assessment of course of the primary fistulous track and secondary extension or
abscesses is required for successful surgical management of anal fistulas. The
purpose of this study was to diagnose and classify pre-operative perianal fistulas.
METHODS
This is a cross-sectional study at Department of Radiodiagnosis in a tertiary level
hospital of southern Rajasthan from November 2018 to November 2020. The study
included a total of 50 patients referred to department of radiology for magnetic
resonance imaging (MRI). Statistical analysis was done using chi square test and
student t test.
RESULTS
Out of these patients, 56 % were having secondary tract on MRI, 12 % patients
were having abscess and 4 % were having horseshoe abscess on MRI. The
commonest type of ano-rectal fistula encountered in the study was Grade -II seen
in 32 %.
CONCLUSIONS
MRI is a highly accurate, rapid and non-invasive tool in pre-operative evaluation
of the perianal and anal fistulas. MRI evaluation and classification of perianal
fistulae has a high degree of diagnostic accuracy. The use of MRI for the diagnosis
and classification of perianal fistula can provide reliable information which has both
pre-operative and prognostic value. St James University Hospital classification,
which is an MR imaging-based grading system for perianal fistula is very useful for
effective radiological-surgical communication thus contributing to improved
patient care and reduced rate of recurrence.
