An observational study of the association of preoperative MRI findings and intraoperative findings in patients with fistula in ano

Abstract

Objective To assess the precision of preoperative MRI pelvis for identification of anal fistulas with regard to intraoperative findings. Patients and methods A prospective observational cohort study was done in the Department of General Surgery, over a period of 18 months (October 2019–April 2021) during which all diagnosed cases of fistula in ano admitted for elective surgery were included and operated by an experienced surgeon. MRI and clinical evaluation were done preoperatively and correlated with intraoperative findings. Patients were followed up for 12 weeks during which recurrence and complications were noted. Results The mean age of the patients was 36.98 years. There were 44 (97.78%) men and one woman. All patients had discharge, 34 (75.56%) had pain, 27 (60%) had constipation, and 35 (77.78%) had pruritus. Intraoperative findings showed that 40 (88.89%) cases had single external opening, while five (11.11%) cases had multiple external openings. MRI was able to correctly diagnose all 40 cases of single external opening, and five cases of multiple external openings with a good kappa agreement with intraoperative findings (K=1.000, P