Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating perianal fistulae, due to its ability to show the relationship of perianal fistulae with anal sphincters, fistula extensions, secondary ramifications and associated complications. To evaluate the role of diffusion-weighted MRI in the evaluation of perianal fistulae. A hospital-based cross-sectional study. The study group composed of 47 patients of perianal fistula. MRI with diffusion-weighted imaging (DWI) was performed with Philips 0.5 T Ingenia scanner. DWI with different -values ( = 50, = 400, and = 800 smm ) were obtained. The MRI findings were correlated with local clinical examination and or surgical findings. Chi-square test, independent samples -test, and receiver operating characteristic curve analysis. Fifty-nine perianal fistulas in 47 patients were included in the study sample. The visibility of perianal fistula on DWI was less than T2-weighted (T2W) and combined DWI-T2W images. Distinctly visualized (visibility score 2) perianal fistulas were observed in 47 fistulas (79.6%) on DWI, 54 (91.5%) on T2W, and 58 (98.3%) on DWI-T2W images. The mean of apparent diffusion coefficient (ADC) values of active fistula was 0.972 ± 0.127 [SD] 10 mm /s and inactive was 1.232 ± 0.185 [SD] 10 mm /s with a significant difference ( -value < 0.0005). A cut-off mean ADC value of 1.105 × 10 mm /s was used to differentiate active from the inactive fistula with a sensitivity of 87.5% and specificity of 73.3%. Combined DWI-T2W evaluation had a better performance in the detection of fistula than DWI or T2W alone. DWI with mean ADC calculation had a good performance in differentiating active from the inactive fistulas.
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http://dx.doi.org/10.1055/s-0041-1729673 | DOI Listing |
Heliyon
January 2025
Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China.
Background: Empirical reviews suggested that cryptoglandular anal fistulas require surgical resolution. However, some reports have indicated the possibility of nonsurgical and conservative treatment, which is discussed in this review.
Methods: This review explores the potential of nonsurgical approaches for curing anal fistulas through bacterial inhibition and immunomodulation.
ACS Biomater Sci Eng
January 2025
Department of Gastrointestinal Surgery, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China.
Perianal fistulas (PAFs) are a severe complication of Crohn's disease that significantly impact patient prognosis and quality of life. While stem-cell-based strategies have been widely applied for PAF treatment, their efficacy remains limited. Our study introduces an injectable, temperature-controlled decellularized adipose tissue-alginate hydrogel loaded with dental pulp mesenchymal stem cells (DPMSCs) for in vivo fistula treatment.
View Article and Find Full Text PDFPrz Gastroenterol
September 2024
Department of Internal Medicine and Gastroenterology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland.
Introduction: Crohn's disease is a chronic, complex inflammatory disorder of the gastrointestinal tract. Among its most challenging complications are perianal fistulas.
Aim: This study aims to explore the efficacy of hyperbaric oxygen therapy (HBOT) in reducing the activity of perianal fistulas in Crohn's disease patients.
Crohns Colitis 360
January 2025
GI Medical, Takeda Pharmaceuticals USA, Inc., Lexington, MA, USA.
Background: Crohn's perianal fistulas (CPF) are difficult to manage and often require multiple interventions. This study aimed to assess the preferences of patients and healthcare professionals (HCPs) for attributes of CPF-related procedures/surgeries to better inform CPF management.
Methods: This US cross-sectional, observational study was conducted via a web-enabled questionnaire (October 2021-January 2022) among patients aged 21-89 years with a self-reported physician diagnosis of CPF (with or without CPF-related surgery experience) and HCPs (gastroenterologists and colorectal surgeons who managed ≥3 patients with CPF in the past 12 months).
Rev Esp Enferm Dig
January 2025
Aparato Digestivo , Hospital Universitario Infanta Sofía.
A 54-year-old male underwent a low anterior resection in 2015 for rectal adenocarcinoma. He presented to the emergency department with a two-week history of fever, perianal pain, an erythematous, warm, and actively draining mass. Physical examination revealed a perianal abscess in the left posterior gluteal region, with a palpable internal fistulous orifice 3 cm from the anal margin.
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