Trans‐Fistula Contrast‐Enhanced Ultrasound in Diagnosing a Complex Anal‐Bartholin‐Perineal Fistula of Crohn's Disease: A Case Report

This case report presents an uncommon presentation of Crohn's disease (CD) complicated by an anal-Bartholin-perineal fistula. Notably, ultrasound was the initial imaging modality to demonstrate suspicious fistulous tract features in this case. Definitively, trans-fistula contrast-enhanced ultrasound (TF-CEUS) clearly visualized the fistula, providing real-time dynamic architectural details that were critical for diagnosis. TF-CEUS emerged as a valuable diagnostic adjunct in this case, offering novel insights into evaluating complex perianal fistulous disorders in CD, particularly when conventional imaging modalities like MRI yield inconclusive results.