Perianal fistulas are a major problem in many patients with Crohn's disease. These are usually complex fistulas that adversely affect patients' quality of life, and their clinical management is difficult. Medical treatment sometimes achieves cessation of discharge and closure of the external opening; however, it is difficult to assess the status of the rest of the fistula tract. Magnetic resona...

BACKGROUND/PURPOSE Fistulotomy is the accepted treatment for infants with perianal fistula. Although recurrence rates range from 0% to 68%. Based on the experience of a senior colleague who noted that babies suffering from perianal fistula follow a self-limited course the authors decided to determine if this observation was accurate. METHODS A conservative approach to perianal abscess and fis...

OBJECTIVE To evaluate the effectiveness of endoanal ultrasound with hydrogen peroxide enhancement in the assessment of anal fistula (tract and internal opening), and to value the utility of this examination for anal or perianal suppuration when performed by a colorectal surgeon trained in this technique. PATIENTS Endoanal ultrasound was performed in 103 patients with anal or perianal suppurat...

Two cases of recurrent perianal suppuration are described in which the underlying pathology is believed to be pilonidal sinus disease affecting the perianal skin directly. This has given rise to intersphincteric fibrosis and, in one case, a subcutaneous track almost completely encircling the anus. The pathogenesis of the condition and its possible relationship to previous surgery are discussed.

PURPOSE To use magnetic resonance (MR) imaging to document the appearance of perianal infection in patients with a hematologic malignancy (HM) compared with that in immunocompetent control patients. MATERIALS AND METHODS After an ethical waiver was obtained, 38 patients with an HM were matched by age and sex to 38 control patients with no history of immunocompromise or Crohn disease. Both gro...