Value of Endoanal Ultrasound in the Comprehensive Management of Crohn's Disease-Associated Anorectal Fistulas: A Case Report.

Crohn's disease frequently involves the perianal region, where complex anal fistulas represent a challenging manifestation due to high recurrence rates and the risk of sphincter injury, as well as fecal incontinence. We report the case of a woman with long-standing Crohn's disease, who developed a complex anal fistula in which endoanal ultrasound (EAUS) was essential for accurate anatomical characterization, assessment of sphincter involvement, and therapeutic planning. Following medical optimization and sphincter-sparing surgery, the patient achieved complete healing with preserved continence. This case highlights the value of EAUS as an effective, accessible, and cost-efficient imaging modality for the evaluation and follow-up of perianal Crohn's disease, supporting individualized management strategies in selected patients.