Incidence and diagnostic performance of ultrasound for perianal abscess or fistula‐in‐ano in pediatric patients with perianal inflammation

Abstract

AbstractObjectivesTo describe the incidence and diagnostic performance of ultrasound for perianal abscess or fistula‐in‐ano in pediatric patients with perianal inflammation.MethodsWe included 45 patients with perianal inflammation who underwent ultrasonography. To demonstrate the diagnostic performance of ultrasound for fistula‐in‐ano, a definite diagnosis of perianal abscess, and fistula‐in‐ano was determined as that proven through magnetic resonance imaging (MRI) or computed tomography (CT). The absence or presence of perianal abscess and fistula‐in‐ano on ultrasonography was recorded.ResultsAmong the 45 patients, on ultrasound, perianal abscess and fistula‐in‐ano were detected in 22 (48.9%) and 30 (68.2%) patients, respectively. Nine patients had MRI or CT and a definite diagnosis of perianal abscess or fistula‐in‐ano; accuracy, negative predictive value, and positive predictive value of ultrasound for perianal abscess were 77.8% (7/9; 95% confidence interval [CI]: 40.0%–97.1%), 66.7% (2/3; 95% CI: 9.4%–99.2%), 83.3% (5/6; 95% CI: 35.9%–99.6%), and those of fistula‐in‐ano were 100% (9/9; 95% CI: 66.4%–100%), 100% (8/8; 95% CI: 63.1%–100%), and 100% (1/1; 95% CI: 2.5%–100%), respectively.ConclusionsPerianal abscess and fistula‐in‐ano were detected by ultrasound in half of the patients with perianal inflammation. Accordingly, ultrasound has an acceptable diagnostic performance for perianal abscess and fistula‐in‐ano.