We read with interest the article by Kleinübing and colleagues concerning the more routine use of transperineal sonography in the surgical delineation of anal fistulas. The case for a selective role for imaging is made by the authors given the heterogeneity of their cases where surgery could no longer be considered the gold standard for detection of the internal opening. This method needs to be prospectively compared with MR imaging and its value in perianal Crohn’s disease confirmed.
Techniques in Coloproctology Vol. 12, Issue 3, p. 264-265