Current applications of transperineal ultrasound in gastroenterology

Figure 1 Standard transperineal ultrasound images. A: Midsagittal view; B: Upper anal canal in the transversal view; C: Transversal view of the middle anal canal. SP: Symphysis pubis; U: Urethra; B: Bladder; V: Vagina; UT: Uterus; R: Rectum; A: Anal canal; PR: Puborectalis muscle; IAS: Internal anal sphincter; EAS: External anal sphincter.

Figure 2 A woman with symptoms of obstructed defecation. A: Transperineal ultrasound at rest; B: Transperineal ultrasound during maximal straining, after rectum filling with ultrasonographic coupling gel, showing a herniation of the anterior rectal wall into the vagina confirming a retocele (arrow). SP: Symphysis pubis; U: Urethra; B: Bladder; V: Vagina; R: Rectum; A: Anal canal; PR: Puborectalis muscle.

Figure 3 A woman with symptoms of obstructed defecation. A: Transperineal ultrasound at rest, after rectum filling with ultrasonographic coupling gel; B: Transperineal ultrasound during maximal straining, after rectum filling with ultrasonographic coupling gel, showing a herniation of the rectal wall into the anal canal confirming a rectal intussusception (arrow). U: Urethra; B: Bladder; V: Vagina; R: Rectum; A: Anal canal.

Figure 4 Transversal view of the anal canal (A) in a case of inflammatory perianal disease, fistula (left image, between lines) and abscess (right image, arrow).