# Value of Endoanal Ultrasound in the Comprehensive Management of Crohn's Disease-Associated Anorectal Fistulas: A Case Report

## TL;DR

A case report shows how endoanal ultrasound helps manage complex anal fistulas in Crohn's disease patients by guiding treatment and preserving continence.

## Contribution

The paper demonstrates the clinical utility of endoanal ultrasound in individualized management of Crohn's disease-associated anorectal fistulas.

## Key findings

- Endoanal ultrasound provided accurate anatomical characterization of a complex anal fistula.
- The patient achieved complete healing with sphincter-sparing surgery after EAUS-guided planning.
- EAUS is proposed as a cost-efficient and accessible imaging modality for perianal Crohn’s disease.

## Abstract

Crohn’s disease frequently involves the perianal region, where complex anal fistulas represent a challenging manifestation due to high recurrence rates and the risk of sphincter injury, as well as fecal incontinence. We report the case of a woman with long-standing Crohn’s disease, who developed a complex anal fistula in which endoanal ultrasound (EAUS) was essential for accurate anatomical characterization, assessment of sphincter involvement, and therapeutic planning. Following medical optimization and sphincter-sparing surgery, the patient achieved complete healing with preserved continence.

This case highlights the value of EAUS as an effective, accessible, and cost-efficient imaging modality for the evaluation and follow-up of perianal Crohn’s disease, supporting individualized management strategies in selected patients.