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During 12 consecutive months, 680 patients with recent pelvic symptoms were examined with ultrasonography (US). In 44 patients we found evidence of intestinal disease; 19 of them exhibited pelvic complications--11 pelvic abscesses, 3 enterovesical fistulas, 2 enterovaginal fistulas and 1 enterovesicle fistula; in 11 cases the inflammation spread to the surrounding organs. Of these 19 patients, 8 had an intestinal disease in their case history, whereas symptom onset was recent in the other 11 patients. In the latter group US yielded the first diagnostic information showing a bowel disease and other diagnostic examinations with different techniques were therefore performed. In 15 patients US indicated which type of bowel disease had caused the pelvic complications, while in 4 patients US showed a bowel disease without differentiating diverticular disease from neoplasms. In all patients US results were compared with X-ray and CT findings. In 17 patients the diagnoses were confirmed at surgery. The results we obtained from this study indicate US as an accurate method to detect not only the various pelvic conditions but also to differentiate pelvic complications of intestinal conditions from diseases originating in the pelvic organs.

Ultrasound is in widespread use in the study of gastrointestinal pathologies. In Crohn disease it is helpful in diagnosing complications such as thickening of the bowel loop walls, abscesses, lymph node enlargement and vesical-enteric fistulas. This report presents two cases in which vesical-enteric fistulas were visualized by US; confirming a diagnosis of Crohn's disease in one case, and diagnosing the fistula during the follow-up in the second patient in whom Crohn's disease had previously been diagnosed.

The study of anorectal malformations has considerably improved over the last years also thanks to the use of such diagnostic techniques as CT and MR imaging, which allow a better knowledge of perineal region anatomy and the demonstration of the development of sphincteric structures. The most important diagnostic phase for the identification of anorectal malformations consists in the detection of rectal fistulas. The authors report on their experience with barred water-soluble contrast enema in the study of anorectal anomalies. Over 2 years, 23 patients with anorectal malformations (10 males and 13 females) previously submitted to colostomy, were studied with this method. Fistulas were detected in 21 cases; in the extant 2 patients (both females affected with Down syndrome), no fistulas were detected, not even at surgery, which was posterior sagittal anorectoplasty according to Peña-De Vries. In our experience, the most frequent anomalies were recto-bulbo-urethral fistula in males and low recto-vaginal fistula in females. The authors suggest the use of this method as a routine diagnostic examination, because of its proven reliability.