CC BY-NC-ND 4.0 · Ultrasound Int Open 2019; 05(01): E34-E51
DOI: 10.1055/a-0825-6708
Eigentümer und Copyright ©Georg Thieme Verlag KG 2019

EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound

Dieter Nuernberg*
1   Medical School Brandenburg Theodor Fontane, Gastroenterology, Neuruppin, Germany
Adrian Saftoiu*
2   Research Center in Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania
Ana Paula Barreiros
3   Deutsche Stiftung Organtransplantation, Head of Organisation Center Middle, Frankfurt, Germany
Eike Burmester
4   Department of Internal Medicine/Gastroenterology, Sana-Kliniken Lübeck, Lübeck, Germany
Elena Tatiana Ivan
2   Research Center in Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania
Dirk-André Clevert
5   Department of Clinical Radiology, Interdisciplinary Ultrasound-Center, University of Munich-Grosshadern Campus, Munich, Germany
Christoph F. Dietrich
6   Caritas-Krankenhaus, Medizinische Klinik 2, Bad Mergentheim, Germany
Odd Helge Gilja
7   National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway
Torben Lorentzen
8   Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
Giovanni Maconi
9   Gastroenterology Unit, Department of Biomedical and Clinical Sciences, “L.Sacco” University Hospital, Milan, Italy
Ismail Mihmanli
10   Istanbul University – Cerrahpasa, Cerrahpasa Medical Faculty, Department of Radiology and ALKA Radyoloji Tani Merkezi, Istanbul, Turkey
Christian Pallson Nolsoe
11   Ultrasound Section, Division of Surgery, Department of Gastroenterology, Herlev Hospital and Copenhagen Academy for Medical Education and Simulation (CAMES), University of Copenhagen, Denmark
Frank Pfeffer
12   Department of Surgery, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway
Søren Rafael Rafaelsen
13   Colorectal Centre of Excellence, Clinical Cancer Centre, University Hospital of Southern Denmark, Vejle, Denmark
Zeno Sparchez
14   3rd Medical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
Peter Vilmann
15   Endoscopy Department, Copenhagen University Hospital Herlev, Herlev, Denmark
Jo Erling Riise Waage
12   Department of Surgery, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway
› Author Affiliations
Further Information

Publication History

received 07 April 2018
revised 23 November 2018

accepted 01 December 2018

Publication Date:
05 February 2019 (online)


This article represents part 3 of the EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound (GIUS). It provides an overview of the examination techniques recommended by experts in the field of endorectal/endoanal ultrasound (ERUS/EAUS), as well as perineal ultrasound (PNUS). The most important indications are rectal tumors and inflammatory diseases like fistula and abscesses in patients with or without inflammatory bowel disease (IBD). PNUS sometimes is more flexible and convenient compared to ERUS. However, the technique of ERUS is quite well established, especially for the staging of rectal cancer. EAUS also gained ground in the evaluation of perianal diseases like fistulas, abscesses and incontinence. For the staging of perirectal tumors, the use of PNUS in addition to conventional ERUS could be recommended. For the staging of anal carcinomas, PNUS can be a good option because of the higher resolution. Both ERUS and PNUS are considered excellent guidance methods for invasive interventions, such as the drainage of fluids or targeted biopsy of tissue lesions. For abscess detection and evaluation, contrast-enhanced ultrasound (CEUS) also helps in therapy planning.

* First 2 authors contributed equally to the manuscript.

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