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DOI: 10.1055/s-0042-1750027
High-Resolution Transperineal Ultrasound in Anorectal Malformations—Can We Replace the Distal Colostogram?
Abstract
Introduction Anorectal malformations (ARM) affect 1 in 5,000 newborns with a wide range of defects. In the absence of a visible fistula, the diagnosis and classification of ARM require an augmented pressure distal colostogram. This procedure can be done after a diverting colostomy has been performed and implies exposing the child to radiation. We hypothesized that high-resolution transperineal ultrasound could correctly diagnose the type of ARM, thus sparing radiation exposure.
Case Description Four full-term male newborns with ARM and no visible anal opening were referred to our center for further management. A diverting descendostomy was performed in the first 48 hours of life in all cases. Prior to the reconstructive surgery, we performed a high-resolution transperineal ultrasound with 3D tomographic reconstruction of the perineal region to assess the urethra, the rectum, and a possible fistula. Findings were compared with a conventional augmented pressure distal colostogram. The image acquisition was fast and did not cause any additional distress to the children.
Conclusion In all cases the results of the distal colostogram nicely correlated with the high-resolution transperineal ultrasound with 3D tomographic reconstruction. In the future, we envision a time when it can potentially replace the distal colostogram in preoperative assessment of ARM with no distress and exposure to radiation.
Disclosure
This case series was presented at the 2021 EUPSA Congress in Athens on September 03, 2021
Publikationsverlauf
Eingereicht: 14. Oktober 2021
Angenommen: 02. März 2022
Artikel online veröffentlicht:
19. Juli 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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References
- 1 Wood RJ, Levitt MA. Anorectal malformations. Clin Colon Rectal Surg 2018; 31 (02) 61-70
- 2 Halleran DR, Ahmad H, Bates DG, Vilanova-Sanchez A, Wood RJ, Levitt MA. A call to ARMs: accurate identification of the anatomy of the rectourethral fistula in anorectal malformations. J Pediatr Surg 2019; 54 (08) 1708-1710
- 3 Bischoff A, Levitt MA, Peña A. Update on the management of anorectal malformations. Pediatr Surg Int 2013; 29 (09) 899-904
- 4 Abdalla WMA, De La Torre L. The high pressure distal colostogram in anorectal malformations: technique and pitfalls. J Pediatr Surg 2017; 52 (07) 1207-1209
- 5 Kraus SJ, Levitt MA, Peña A. Augmented-pressure distal colostogram: the most important diagnostic tool for planning definitive surgical repair of anorectal malformations in boys. Pediatr Radiol 2018; 48 (02) 258-269
- 6 Bischoff A, Bealer J, Wilcox DT, Peña A. Error traps and culture of safety in anorectal malformations. Semin Pediatr Surg 2019; 28 (03) 131-134
- 7 Kavalcova L, Skaba R, Kyncl M, Rouskova B, Prochazka A. The diagnostic value of MRI fistulogram and MRI distal colostogram in patients with anorectal malformations. J Pediatr Surg 2013; 48 (08) 1806-1809
- 8 Krois W, Palmisani F, Gröpel P. et al. Assessment of sacral ratio in patients with anorectal malformations: Can magnetic resonance imaging replace conventional radiograph?. J Pediatr Surg 2021; 56 (11) 1993-1997
- 9 Köchling J, Pistor G, Märzhäuser Brands S, Nasir R, Lanksch WR. The Currarino syndrome–hereditary transmitted syndrome of anorectal, sacral and presacral anomalies. Case report and review of the literature. Eur J Pediatr Surg 1996; 6 (02) 114-119