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Introduction- Fistula-in-ano can be dened as a hollow tract or cavity which is lined by granulation tissue. It is crucial to properly assess these stula-in-ano because surgical intervention must be aimed at not only eradication of stulous tract thereby eradication of source of infection but also at the maintenance of continence which depends on intergrity of anal-sphincter complex. MR stulography has the distinct advantage of not only depicting the stulous tract but also in demonstrating the extent of transmural inammatory process secondary tracts/ramications and abscesses. The aim of the study is to evaluate role of MRI in appropriate diagnosis of Grade IV perianal stulae – Complicated transsphincteric stulae (Saint James's University Hospital Classication) with its post operative correlation. Around 19 patients who were Methodologydiagnosed with grade IV perianal stula (according to Saint James classication) on MR stulogram in the Department of Radiology were included in the study and followed up with their post operative data. A male preponderance Results And Discussion - reported in our study, correlating well with studies by others like Kakani SS et al., Daabis N et al. and Abbas et al. Purulent perianal discharge was common presenting complaints. Most common location for internal opening was posterior position which was also seen in a study by Choudhary J, Kaushal L, Rajput P. Out of the total 19 patients, extrasphincteric abscess/collection was more commonly found in the patients. Majority of the patients had secondary tracts and ramications. In this study accuracy for correct localization of internal opening was (93.33%), identication of ramications/secondary tracts was (92.85 %) and abscesses/collection was (90 %) as compared to operative ndings which correlated well with studies by Singh K et al., Daabis et al. and Madireddy et all MRI is a useful modality for diagnosis and successful mana . Conclusion- gement of grade IV perianal stula. MRI helps in detailed assessment of the number & extent of the stulous tracts and their relationship to anal sphincter complex, including ramications, thereby reducing the recurrence & complications and improving the prognosis. |
