The importance of ultrasound findings in the study of anal pain

• Published in: Revista española de enfermedades digestivas Vol. 102; no. 5; pp. 308 - 313
• Main Authors: Vieira, A M, Castro-Poças, F, Lago, P, Pimentel, R, Pinto, R, Saraiva, M M, Areias, J
• Format: Journal Article
• Language: English; Portuguese
• Published: Spain Sociedad Española de Patología Digestiva 01.05.2010
• Subjects: Adult; Aged; Anal Canal - diagnostic imaging; Chronic Disease; Defecation; Female; Fissure in Ano - diagnostic imaging; Gastroenterology & Hepatology; Geriatrics & Gerontology; Humans; Infectious Diseases; Male; Manometry; Middle Aged; Oncology; Pain - diagnostic imaging; Pathology; Pharmacology & Pharmacy; Radiology, Nuclear Medicine & Medical Imaging; Retrospective Studies; Sepsis - etiology; Surgery; Ultrasonography; Endoanal ultrasonography; Dolor anal crónico; Proctalgia fugax; Ultrasonografía endoanal; Chronic anal pain; Dolor anal; Anal pain; Proctalgia fúgax
• ISSN: 1130-0108
• DOI: 10.4321/S1130-01082010000500004

Endoanal ultrasonography can detect organic causes of anal pain without pathology on physical examination. The aim of this study is to evaluate the importance of endoanal ultrasonography in the diagnosis and therapeutic management of idiopathic and functional anal pain. Retrospective study, between 15 March 2005 and 15 June 2008, of all patients with proctalgia and normal examination or with alterations not responsible for anal pain at proctologic exam that have undergone an endoanal ultrasonography. A total of 90 patients were analyzed, with a mean age of 50.5 years, 58% were female. Twenty-three patients had functional anal pain clinic criteria. Endoanal ultrasonography revealed alterations in 49% of patients. The primary findings were changes in sphincters in 14 patients, followed by anal sepsis in 12 patients, anal fissure in 10 patients, perirectal lesions in 6 patients and ulcer of the anal canal in 2 patients. Of the patients with sphincter defects, 5 patients had criteria of chronic anal pain. In this group of patients, no differences were found in manometric and defecographic results between the different ultrasound abnormalities. The endoanal ultrasonography detected occult organic lesions to proctologic examination, in half the patients with anal pain. Ultrasound abnormalities were found in 22% of patients with functional anal pain. However, there was no correlation between ultrasound findings and physiological studies, and therefore could not find etiological or pathogenic factors of functional anal pain.