En 55 casos había antecedentes de cirugía anal. Se detectaron 11 lesiones y se descartó una lesión en una de las 7 pacientes con clara referencia de traumatismo obstétrico. Se visualizó lesión esfinteriana en 51 de los 55 pacientes operados por cirugía anal. Conclusiones. La elevada incidencia de lesiones detectadas y la confirmación de todas aquellas operadas demuestran una gran utilidad y fiabilidad de la ecografía endoanal. Mediante esta técnica ha sido posible visualizar un gran número de lesiones de esfínter interno que anteriormente no podían ser detectadas. La ecografía endoanal pone en evidencia el riesgo de incontinencia tras la cirugía anal denominada "menor".
Introduction. The objective of the present report is to analyze the experience of the Coloproctology Unit of the Hospital Mútua de Terrassa, Spain, in the use of endoanal ultrasonography to study patients with fecal incontinence.
Patients and methods. Ninety-eight patients were studied. The technique and the ultrasonographic features are described.
Results. Of the 98 patients with fecal incontinence studied, 72 (73%) presented sphincteric lesions, corresponding to internal sphincter in 17 cases, to external sphincter in 26 and to both in 29. Seven patients had a history of dystocic deliveries. In 55 cases, the patients had undergone earlier anal surgery. Eleven lesions were detected and the presence of a lesion was ruled out in one of the 7 patients, who clearly was found to present obstetric trauma. Sphincteric lesions were found in 51 of the 55 patients who had undergone anal surgery.
Conclusions. The elevated incidence of lesions detected and the confirmation of all those treated surgically demonstrates the great utility and reliability of endoanal ultrasonography. It discloses a large number of lesions of internal sphincter which used to be undetectable. Endoanal ultrasonography reveals the risk of incontinence after so-called "minor" anal surgery
