Anal (EcoA) and rectal endosonography
(EcoEAR) is a useful test in the evaluation of patients with anorectal
pathology. However, there is no clear consensus on its indications.
The aim of this study was to determine the
opinion of clinicians regarding the current indications and usefulness of this
diagnostic test in daily clinical practice. A cross-sectional observational
study was conducted using a survey sent to the services of General surgery in a
specific area of Spain. The clinical usefulness of the test was evaluated using
an analog scale from 0 (lowest value) to 10 (maximum utility) for each
pathology. Of the 47 hospitals, 23 responded to the questionnaire (48.9%). The
average number of ultrasounds performed in these centers was 217 per year
(standard deviation: 140.1, range 73–450) during the last 3 years. The most
common indications for this test were: rectal tumor (85%), anal fistula (80%),
and fecal incontinence (70%). This test was suggested more, depending on
availability in the hospital itself.
In conclusion, anal and rectal endosonography
remains a very useful diagnostic clinical test in the opinion of clinicians in
general and digestive surgery, especially in the evaluation of patients with
anal fistula, fecal incontinence, or rectal tumors.
Fig. 2: Anal
endosonography imaging in a patient with fecal incontinence showing internal
anal sphincter injury (arrows).
Fig. 3: 3D rectal
endosonography imaging showing the presence of a rectal tumor (arrows).
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