The Efficacy of Endoanal Sonography in Treatment of Patients with Anal Diseases Referred to Shiraz Colorectal Surgery (SCRS) Department Since 2011


avatar Ensieh Izadpanah 1 , * , avatar Ahmad Izadpanah 2 , avatar Vahid Hosseini 3 , avatar Mehrzad Lotfi 1 , avatar Leila Ghahremani 3 , avatar Ali Mohammad Bananzadeh 3

Department of Radiology, Shiraz University of Medical Sciences, Shiraz, IR Iran
Colorectal Surgery Research Center
Shiraz Colorectal Research Center

how to cite: Izadpanah E, Izadpanah A, Hosseini V, Lotfi M, Ghahremani L, et al. The Efficacy of Endoanal Sonography in Treatment of Patients with Anal Diseases Referred to Shiraz Colorectal Surgery (SCRS) Department Since 2011. Innov J Radiol. 2014;11(30th Iranian Congress of Radiology):e21280.



Different diagnostic modalities have been used in treatment of patients with anal diseases who have referred to Shiraz colorectal surgery (SCRS) department in the past 7 years. These modalities include anoscopy, manometry, endoanal sonography, MRI and EMG in addition to clinical evaluation. Among these modalities, endoanal sonography looks like the first choice of SCR surgeons, and with their increasing reliance on ultrasound findings, the rate of using other modalities have declined among in recent years.

Patients and Methods:

To evaluate the efficacy of endoanal songraphy on treatment planning of patients with anal diseases, we reviewed the notes of patients who had anal sonography prior to treatment by using Medtronic 360 degree endoanal sonography device. We focused on decision making efficacy of this modality and its diagnostic accuracy.


Endoanal sonography was done in 1418 patients from March 2011 to December 2013. In 83% of patients anal canal structure was normal, and in 17% of patients, pathological findings such as anal canal tumor, peri-anal fistula and anal sphincter muscle damage were found. Comparing to other modalities, endoanal sonography had most accuracy in diagnosis of patients with fecal incontinence and was very helpful for colorectal surgeons in decision making for patients with anal canal tumors. In 5 patients with anal canal tumor, primary decision of local excision was changed to AP resection because of detecting T2 or T3 involvements. In 2 patients who insisted on local excision, deep tissue involvement was revealed on histopathology. In patients with incontinence due to sphincter damage, the detected site of damage was accurate in 100% of patients, and colorectal surgeons could confidently rely on sonography findings for approach to the site of sphincter defect. In 15 patients with longstanding anal pain, a small peri-anal cold abscess was detected on endoanal sonography. These abscesses had not been diagnosed prior to ultra sound scanning and were eventually approached and treated under the guide of sonography. Conclusion: Endoanal sonography can be the best modality in detection of anal canal diseases if there is close cooperation between radiologists and colorectal surgeons.

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