CC BY-NC-ND 4.0 · Journal of Coloproctology 2015; 35(01): 053-058
DOI: 10.1016/j.jcol.2014.09.002
Original Article

The importance of three-dimensional anorectal ultrasound in the study of patients with anal pain

A importância da ultra-sonografia anorretal tridimensional no estudo de pacientes portadores de dor anal
Doryane Maria dos Reis Lima
a   Medical Course, Faculdade Assis Gurgacz (FAG), Cascavel, PR, Brazil
b   Gastroclínica Cascavel Ltda., Cascavel, PR, Brazil
,
Univaldo Etsuo Sagae
a   Medical Course, Faculdade Assis Gurgacz (FAG), Cascavel, PR, Brazil
b   Gastroclínica Cascavel Ltda., Cascavel, PR, Brazil
,
Gustavo Kurachi
a   Medical Course, Faculdade Assis Gurgacz (FAG), Cascavel, PR, Brazil
b   Gastroclínica Cascavel Ltda., Cascavel, PR, Brazil
,
Salua Hamaoui
a   Medical Course, Faculdade Assis Gurgacz (FAG), Cascavel, PR, Brazil
b   Gastroclínica Cascavel Ltda., Cascavel, PR, Brazil
,
Tomaz Massayuki Tanaka
a   Medical Course, Faculdade Assis Gurgacz (FAG), Cascavel, PR, Brazil
b   Gastroclínica Cascavel Ltda., Cascavel, PR, Brazil
,
Mauro Willemann Bonatto
a   Medical Course, Faculdade Assis Gurgacz (FAG), Cascavel, PR, Brazil
b   Gastroclínica Cascavel Ltda., Cascavel, PR, Brazil
,
Ricardo Shigueo Tsuchiya
a   Medical Course, Faculdade Assis Gurgacz (FAG), Cascavel, PR, Brazil
b   Gastroclínica Cascavel Ltda., Cascavel, PR, Brazil
,
Carlos Alberto de Carvalho
a   Medical Course, Faculdade Assis Gurgacz (FAG), Cascavel, PR, Brazil
b   Gastroclínica Cascavel Ltda., Cascavel, PR, Brazil
› Author Affiliations

Abstract

Objectives Anal pain can be caused by various medical conditions; the exclusion of organic causes for proper treatment is important. Three-dimensional anorectal ultrasound can identify organic causes of anal pain. The objective of this study was to evaluate the importance of three-dimensional anorectal ultrasound in the detection of organic abnormalities in patients with anal pain.

Methods Twenty-two patients (mean age: 49 years; 13 women) with chronic anal pain were enrolled to join a prospective study between June 2009 and June 2011. A complete proctology and colonoscopy examination was normal. Subsequently, the patients underwent three-dimensional anorectal ultrasound.

Results Intersphincteric sepsis was found in 14 patients (63.6%). Two female patients (9.1%) had anal sphincter injury, one of them with the presence of a grade II rectocele. There was an increase in the thickness of the subepithelial tissue in three patients (13.6%). In one patient (4.6%), the presence of a hypoechoic circular retrorectal (presacral) cyst of the middle and lower rectum was observed. The three-dimensional anorectal ultrasound examination showed no abnormalities in two patients (9.1%).

Conclusion The three-dimensional anorectal ultrasound is a simple, economical, fast and useful test for the study of anorectal diseases and should be included in the examination of patients with anal pain, to exclude organic causes.

Resumo

Objetivos A dor anal pode resultar várias condições clínicas e se faz necessário excluir causas orgânicas para o tratamento adequado. A ultra-sonografia anorretal tridimensional (3D-US) pode identificar causas orgânicas de dor anal. O objetivo deste estudo foi avaliar a importância da 3D-US para detectar anomalias orgânicas em pacientes com dor anal.

Métodos Vinte e dois pacientes (média de idade: 49 anos; treze mulheres) com dor anal crônica foram incluídos em um estudo prospectivo entre junho de 2009 e junho de 2011. O exame proctológico completo e colonoscopia foram normais. Posteriormente, os pacientes foram submetidos à 3D-US.

Resultados Sepse interesfincteriana foi evidenciada em quatorze pacientes (63,6%). Duas pacientes (9.1%) apresentaram lesão do esfíncter anal, sendo uma com presença de retocele grau II. O aumento da espessura do tecido subepitelial apresentou-se em três pacientes (13,6%). Em um paciente (4,6%), foi evidenciada a presença de cisto retrorretal circular hipoecoico no reto médio e inferior. O exame de US-3D não evidenciou anormalidades em dois indivíduos (9.1%).

Conclusão A ultra-sonografia anorretal tridimensional é um exame simples, econômico, rápido e útil no estudo de doenças anorretais e deve ser incluído no estudo dos pacientes com dor anal para descartar causas orgânicas.



Publication History

Received: 14 May 2014

Accepted: 12 September 2014

Article published online:
17 February 2021

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