Ecofistulografía como herramienta diagnóstica en el tratamiento de la fístula perianal

Objective: To demostrate the effectiveness of fistulography in the identification of anal fistulas. Study performed at the General Surgery Service 2 of the Hospital Domingo Luciani, Caracas. Patients and method: This is a prospective, descriptive and transversal study of all the patients consulting with perianal discharge, in a period between October 2008 and July 2009. For fistulography it was used a tridimentional ultrasonographic Profocus Blue of BK Medical®, with a 2050 of 360o transductor. All the studies were done by the same explorer.Results: There were included 41 patients, 37 males, and 4 females; with ages between 20 and 70 years old. We found 7 inter-sphinteric fistulas, 10 trans-sphinteric, 2 extra-sphinteric, 1 supra-sphinteric and 2 horseshoe fistulas. In 4 patients, secondary tracks were identified. In 5 studies we found one or more abscesses cavities and internal opening was demostrated in 23 patients, and tracks were measured. The relationships with sphinteric complex was described in 27 patients. Conclusions: Tridimentional trans-anal sonography is considereda very important diagnostic tool in the management of anal fistula. It helps to decide the surgical strategy. With this method we can decrease the number of recidivies and complications, also is an economic, fast and well tolerated study.