Pal P, Mateen MA, Pooja K, Gupta R, Tandan M, Reddy DN. Transperineal ultrasound: Role in inflammatory bowel disease management. World J Gastroenterol 2025; 31(33): 109811 [DOI: 10.3748/wjg.v31.i33.109811]
Corresponding Author of This Article
Partha Pal, MD, FASGE, MRCP, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661 Red Rose Cafe Lane, Sangeet Nagar, Somajiguda, Hyderabad 500082, India. partha0123456789@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Sep 7, 2025; 31(33): 109811 Published online Sep 7, 2025. doi: 10.3748/wjg.v31.i33.109811
Transperineal ultrasound: Role in inflammatory bowel disease management
Partha Pal, Mohammad Abdul Mateen, Kanapuram Pooja, Rajesh Gupta, Manu Tandan, Duvvuru Nageshwar Reddy
Partha Pal, Kanapuram Pooja, Rajesh Gupta, Manu Tandan, Duvvuru Nageshwar Reddy, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad 500082, India
Mohammad Abdul Mateen, Department of Diagnostic Radiology and Imaging, Asian Institute of Gastroenterology, Hyderabad 500082, India
Author contributions: Pal P conceptualized the work, performed the literature search, wrote the first draft, and provided intellectual input; Mateen MA conceptualized the work, supervised the writing and critically revised the manuscript; Pooja K performed literature search, wrote the first draft and revised the manuscript; Gupta R supervised the literature search, and the writing, provided intellectual input and critically revised the manuscript; Tandan M supervised the literature search, and the writing, provided intellectual input and critically revised the manuscript; Reddy DN supervised the writing, provided intellectual input and critically revised the manuscript.
Conflict-of-interest statement: Partha Pal has received consultancy fees from Johnson and Johnson, and other authors have no relevant conflicts of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Partha Pal, MD, FASGE, MRCP, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661 Red Rose Cafe Lane, Sangeet Nagar, Somajiguda, Hyderabad 500082, India. partha0123456789@gmail.com
Received: May 23, 2025 Revised: June 16, 2025 Accepted: August 13, 2025 Published online: September 7, 2025 Processing time: 102 Days and 5.3 Hours
Abstract
Transperineal ultrasound (TPUS) is a non-invasive, real-time imaging technique increasingly utilized for the evaluation of anorectal and pelvic floor disorders in patients with inflammatory bowel disease (IBD). In ulcerative colitis, it enables accurate assessment of rectal wall thickness and vascularity, which correlate closely with both endoscopic and histological inflammation. This makes it a practical alternative to sigmoidoscopy, especially in settings such as pregnancy, childhood, or long-term disease monitoring. In Crohn’s disease, TPUS offers high diagnostic accuracy for detecting, classifying, and monitoring perianal fistulas and abscesses. It is also effective for evaluating rectovaginal fistulas and pouch-related complications following restorative proctocolectomy. Advancements such as color Doppler imaging, contrast-enhanced ultrasound, three-dimensional reconstruction, and computer-assisted grayscale analysis further enhance its diagnostic and functional capabilities. Compared to magnetic resonance imaging and endoscopic ultrasound, TPUS serves as a practical, patient-friendly, and cost-effective frontline or complementary imaging tool for comprehensive disease evaluation and treatment planning-particularly useful in children, pregnant women, and resource-limited settings. Its bedside feasibility, repeatability, and expanding role in treatment monitoring underscore its value in modern IBD care pathways.
Core Tip: Transperineal ultrasound (TPUS) is a non-invasive, bedside imaging tool for assessing anorectal inflammation and fistulizing disease in patients with inflammatory bowel conditions. It enables real-time evaluation of rectal inflammation in ulcerative colitis and offers reliable detection and monitoring of perianal fistulas and abscesses in Crohn’s disease. Its utility extends to children, pregnant women, and patients with pouch-related complications after surgery. Enhanced techniques-such as Doppler imaging, contrast administration, three-dimensional ultrasound, and computerized analysis-expand its diagnostic power. TPUS serves as a practical, repeatable, and cost-effective imaging option, especially as a first-line screening tool or when magnetic resonance imaging is unavailable, contraindicated, or impractical.
