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Abstract
Perianal sepsis are common anal conditions. Anatomically complex perianal fistulae are rare conditions. Complex perianal fistulas comprise any fistula for which simple fistulotomy poses a serious threat to continence. Because of the risk of incontinence, complex fistulas should be treated by techniques that do not divide the sphincter complex.
The effective surgical treatment requires identification of the primary tract and laying open as well as marsupilization of all secondary extensions to avoid recurrence. In order to accurately outline the anatomy of the fistula mid its relation to the sphincter complex, different imaging techniques were employed. Fistula anatomy in complex cases should be imaged in a way that is directly related to surgical planes and exploration. Tistulography and MR! were employed as being (he most currently helpful imaging techniques for complex perianal fistulas.
Twenty complex fistulas were studied regarding the relative accuracy and reliability of different imaging techniques in relation to the classical Gold Standard of examination under anaesthesia including digital rectal examination, probing and injection of dyes. Routine histopathological examination was done in every case. The study revealed that all patients with