Our Summary

This research article talks about the challenges of using magnetic resonance imaging (MRI) to assess anal fistulas after surgery. An anal fistula is an abnormal tunnel between the rectum and the skin near the anus, which can be diagnosed using an MRI. There are many studies that guide how to read an MRI before surgery, but there is very little information available on how to interpret an MRI after the operation.

This article explores the difficulties in understanding post-surgery MRIs, when these should be carried out, and how useful they are in managing anal fistulas after surgery. It also highlights the importance of having an experienced clinician involved in reading the MRI scans. Finally, the paper discusses recent advancements in this field.

FAQs

  1. Why is it challenging to assess anal fistulas using MRI after surgery?
  2. When should a post-surgery MRI be carried out for anal fistulas?
  3. Why is the involvement of an experienced clinician important in reading post-surgery MRI scans for anal fistulas?

Doctor’s Tip

A doctor might advise a patient undergoing anal fistula surgery to follow post-operative care instructions closely, including keeping the surgical area clean and dry, taking prescribed medications as directed, and attending follow-up appointments for MRI scans to monitor healing progress. It is important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients with anal fistulas who are experiencing recurrent infections, abscesses, or pain are typically recommended for surgery. Surgery is often considered when conservative treatments such as antibiotics or drainage procedures have not been effective. Additionally, patients with complex or multiple fistulas may also be candidates for surgery.

It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if surgery is the best course of action for their specific situation. Additionally, patients should be aware of the potential risks and complications associated with anal fistula surgery and discuss these with their healthcare provider before making a decision.

Timeline

Before anal fistula surgery:

  1. Patient experiences symptoms such as pain, swelling, discharge, and recurrent abscesses near the anus.
  2. Patient undergoes a physical examination and diagnostic tests, such as a digital rectal exam and MRI, to confirm the presence of an anal fistula.
  3. Surgical consultation is scheduled to discuss treatment options and the risks and benefits of surgery.

After anal fistula surgery:

  1. Patient undergoes the surgery to remove the fistula tract and repair the anal sphincter muscles.
  2. Patient is monitored in the hospital for a few days post-surgery for any complications.
  3. Patient is discharged with instructions for wound care and follow-up appointments.
  4. Patient may experience pain, discomfort, and drainage from the surgical site in the immediate postoperative period.
  5. Patient follows up with their healthcare provider for wound checks and to monitor for any signs of infection or recurrence of the fistula.
  6. Patient may undergo follow-up imaging, such as an MRI, to assess the healing of the surgical site and to identify any recurrent or persistent fistula tracts.
  7. Patient continues to follow up with their healthcare provider for long-term monitoring and management of their anal fistula.

What to Ask Your Doctor

Some questions a patient should ask their doctor about anal fistula surgery include:

  1. How will the surgery be performed and what are the potential risks and complications?
  2. What is the expected recovery time after the surgery?
  3. How will my pain be managed after the surgery?
  4. Will I need any follow-up procedures or treatments after the surgery?
  5. How will my condition be monitored post-surgery, and when should I expect to have an MRI done to assess the fistula?
  6. What should I look out for in terms of signs of infection or other complications after the surgery?
  7. How experienced is the clinician who will be reading and interpreting my post-surgery MRI scans?
  8. What are the potential outcomes of the surgery, and what are the chances of the fistula recurring?
  9. Are there any lifestyle changes or precautions I should take after the surgery to prevent future issues with the fistula?
  10. Are there any alternative treatments or therapies that I should consider in conjunction with the surgery?

Reference

Authors: Garg P, Kaur B, Yagnik VD, Dawka S, Menon GR. Journal: World J Gastroenterol. 2021 Sep 7;27(33):5460-5473. doi: 10.3748/wjg.v27.i33.5460. PMID: 34588745