METHOD FOR ULTRASONIC NAVIGATION OF OBLITERATED EXTERNAL FISTULAR HOLE WITH FOLLOWING ITS CONTRASTING FOR TOPICAL DIAGNOSTICS OF FISTULA TRACT DURING CHRONIC PARAPROCTITIS Russian patent published in 2019 - IPC A61B8/08 A61B8/12 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to coloproctology and beam diagnostics, and can be used for ultrasonic navigation obliterated external fistulous hole with its further contrasting for topical diagnosis of fistulous passage in chronic paraproctitis. Endorectal ultrasonography is carried out using an endorectal sensor with a scanning frequency of 10 MHz to determine an internal fistulous opening, linear dimensions of fistulous passage, condition of surrounding cellular spaces with detection of perianal leaks and their connection with fistulous main passage. After cleansing enema of patient's intestinal contents on day of examination, perineal ultrasonography of external fistulous opening is made using linear sensor with scanning frequency of 10 MHz with determination of obliteration of outer opening of fistulous passage with determination of angle of fistulous passage in relation to surface of skin. That is followed by local antiseptic treatment and local anesthesia by applying the skin on the surface of the obliterated fistulous passage of "Catedjel" gel. In the patient's elbow-elbow position or lying on the left side, an endorectal sensor is inserted into the patient's anal canal. Under its control, an external fistulous opening is widened by inserting a button probe under a pre-determined fistulous passage angle. Fistulous passage is contrasted by introduction of 1.5 % hydrogen peroxide solution in volume of 5–10 ml through its external hole using an X-ray contrast cannula until penetration of hydrogen peroxide solution into the lumen of the anal canal through the inner fistula opening and filling the internal volume of the fistulous passage and all its sagging gas bubbles. Using the endorectal sensor previously placed in the patient's anal canal, an ultrasonic topical diagnosis of the fistulous passage, its tortuosity and sagging in the cellular spaces is performed, its topical location in relation to the portions of the external sphincter of the anus. Cannula D 18G (1.3 mm) is used as an X-ray contrast cannula in contrasting the fistulous passage.

EFFECT: method provides objectification and sufficient degree of accuracy of topical location of internal and external fistulous holes, as well as a fistulous passage along the entire length and determining the presence or absence of purulent swells and additional spurs in the cellular spaces by using endorectal and perineal ultrasonic examinations, button probe and introducing 1½ % solution of hydrogen peroxide in amount of 5–10 ml using a radiopaque cannula.

1 cl, 3 ex