Transperineal ultrasonography for evaluation of the perianal fistula and abscess in pediatric Crohn disease: preliminary study

Abstract

Purpose: To assess the feasibility and effectiveness of transperineal ultrasonography (TPUS) for the evaluation of perianal Crohn’s disease (PCD) in pediatric patients. Methods: Between September 2010 and August 2013, 64 TPUS examinations were performed in 43 patients (34 males and 9 females; mean age ± standard deviation, 13.3 ± 2.4 years; age range, 6–17 years) to evaluate the PCD. The pain severity, location and activity of perianal fistula, the presence of an abscess, and anal canal hyperemia was retrospectively evaluated. Spearman’s rank correlation analysis was performed to assess the relationship between the severity of the pain and the fistula activity, the presence of an abscess, and anal canal hyperemia. Results: All examinations were successfully performed Thirty-nine examinations (60.9%) were performed without any pain experienced by the patient, 19 examinations (29.7%) with mild pain, five examinations (7.8%) with moderate pain, and one examination (1.6%) with severe pain. The pain severity was correlated with the fistula activity (P<0.01). An anterior fistula location was more common than a posterior location. Active fistulas and abscesses were identified during 30 (48.4%) and 12 (18.8%) examinations, respectively. Anal canal hyperemia was identified in 31 (48.4 %) examinations. Conclusion: TPUS with color Doppler study is useful for visualizing the perianal fistula or abscess and for assessing their inflammatory activity in pediatric Crohn patients.

Keywords

• Ultrasonography
• Transperineal
• Crohn disease
• Pediatric