What is the evidence that endoanal ultrasound accurately predicts recurrence risk after fistula repair compared with postoperative clinical follow-up alone

What is known

- EAUS accurately delineates cryptoglandular and Crohn's perianal fistula/abscess anatomy and is equally sensitive to endoanal MRI for fistula detection. ^1–3 - The described benefit is preoperative mapping to avoid missed tracts, which lowers persistence/recurrence indirectly — not a validated recurrence-prediction test. ^1,2 - Where recurrence prediction is discussed, it is attributed to preoperative MRI outperforming exam under anesthesia, not to EAUS. ⁴

What is unknown / caveats

- No study in the corpus compares EAUS-based recurrence prediction against clinical follow-up alone - EAUS chunks are diagnostic-accuracy/anatomic-mapping studies, not prognostic recurrence models - Postoperative-EAUS data is limited and lesion-specific (e.g., plug failure), not generalizable recurrence prediction - No retrieved study reports the sensitivity/specificity or predictive value of EAUS for recurrence versus clinical follow-up.

## References

1. Felt-Bersma RJ. Endoanal ultrasound in perianal fistulas and abscesses. Dig Liver Dis. 2006;38(8):537-43. PMID: 16627017.

2. Visscher AP, Felt-Bersma RJ. Endoanal ultrasound in perianal fistulae and abscesses. Ultrasound Q. 2015;31(2):130-7. PMID: 25364961.

3. PMID: 22513437. (metadata not in corpus)

4. Botti F, Losco A, Viganò C, Oreggia B, Prati M, Contessini Avesani E. Imaging techniques and combined medical and surgical treatment of perianal Crohn's disease. J Ultrasound. 2015;18(1):19-35. PMID: 25767636.

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_Draft — generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._