Gastro-intestinale chirurgie en gastro-enterologie. XIII. Classificatie en diagnostiek van perianale fistels

- Intersphincteric abscesses due to inflammation of an anal gland are the origin of most perianal fistulas.

- Perianal fistulas are classified into four types. Intersphincteric and transsphincteric fistulas are the most common. The appropriate surgical treatment of perianal fistulas is dependent upon their correct classification.

- Despite new imaging-techniques, physical examination of the perianal region remains of paramount importance for the preoperative classification of perianal fistulas.

- At present, endoanal ultrasound with the injection of hydrogen peroxide into the fistulous tract, is advocated as the most suitable method for the preoperative imaging of perianal fistulas.