Guidelines on postoperative magnetic resonance imaging in patients operated for cryptoglandular anal fistula: Experience from 2404 scans

World J Gastroenterol. 2021 Sep 7;27(33):5460-5473. doi: 10.3748/wjg.v27.i33.5460.


Magnetic resonance imaging (MRI) is considered the gold standard for the evaluation of anal fistulas. There is sufficient literature available outlining the interpretation of fistula MRI before performing surgery. However, the interpretation of MRI becomes quite challenging in the postoperative period after the surgery of fistula has been undertaken. Incidentally, there are scarce data and no set guidelines regarding analysis of fistula MRI in the postoperative period. In this article, we discuss the challenges faced while interpreting the postoperative MRI, the timing of the postoperative MRI, the utility of MRI in the postoperative period for the management of anal fistulas, the importance of the active involvement and experience of the treating clinician in interpreting MRI scans, and the latest advancements in the field.

Keywords: Anal fistula; Hyperintensity; Internal opening; Magnetic resonance imaging; Postoperative.

Publication types

  • Review

MeSH terms

  • Anal Canal
  • Humans
  • Magnetic Resonance Imaging
  • Postoperative Period
  • Radionuclide Imaging
  • Rectal Fistula* / diagnostic imaging
  • Rectal Fistula* / surgery