DOI: https://doi.org/10.22141/2306-2436.6.4.2017.123506

Combined technique of ultrasound diagnosis in chronic paraproctitis and substantiation of the extent of surgical intervention

Ya.P. Feleshtynskyi, Ye.Ye. Born, V.V. Smishchuk

Abstract


Background. The purpose of the study is to evaluate possibilities of the combined method of ultrasound examination in patients with chronic paraproctitis and to substantiate the extent of surgical intervention. Materials and methods. 114 patients of both sexes (66 men, 48 women) aged 25 to 59 years participated in the study and were diagnosed on the basis of the survey for chronic paraproctitis. Comprehensive survey was conducted using the traditionally accepted methods. Additionally, a combined ultrasound examination was performed. This technique was applied within one day before surgery using of an ultrasound scanner SLE-101PC by a double (abdominal and transrectal) technique with 3.5 MHz sensors 5–7.5 MHz, respectively. Results. Our preoperative ultrasound examination in all patients with chronic paraproctitis has allowed to objectively confirm its high informativeness regarding the identification of the internal openings of the fistulas and their branches. 110 patients (96.49 %) were objectively diagnosed to have an internal opening of the fistula. In this case, additional branching of the fistula was determined in 95 patients (83.3 %). Conclusions. 1. At the preoperative stage, a combined ultrasound study should be used in patients with chronic paraproctitis to provide a clear determination of the localization of the inflammatory focus, to trace the fistulous tract, and to detect its internal opening in patients with chronic paraproctitis. 2. In patients with complex pararectal fistulas, in case of combination with the infiltrative-inflammatory process in pararectal tissue, it is advisable to use the contrast technique of ultrasound examination. The combined ultrasound and contrast technique allowed to reveal the internal fistula opening in 96.7 % of patients, branching and infiltrative-inflammatory changes in pararectal tissue — in 83.3 %, which allowed to determine the adequate extent of surgical intervention.


Keywords


chronic paraproctitis; fistula; abdominal and trans­rectal ultrasound examination; rectal sensor

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