Paediatric anal endosonography

Abstract

This study details the endosonographic appearances of the anal canal in healthy children aged from 1 month to 14 years. AES provided useful anatomical detail in patients following anorectoplasty.

Anal endosonography is useful for postoperative assessment of anorectal malformations

“…In a small series of 15 patients with intermediate and high malformations, AES images of the EAS corresponded with electromyographic findings; but the appearance of the IAS did not correspond with anal canal pressures [17]. That AES can be helpful when reoperation is considered for an eccentrically placed anal opening has been reported by us and others [6][7][8]18].…”

“…The accuracy of AES in the assessment of the anal sphincters has been validated by comparison with dissected autopsy material and histologic findings after surgery [4,5]. Despite the extensive use of AES in adults, there are few reports of its use in children with anorectal malformations (ARM) [6][7][8].…”

Embryonic development of the internal anal sphincter in rats with anorectal malformations

“…In a prior anatomical study, IAS has been regarded as a missing or hypoplastic structure in patients with high and intermediate ARMs Therefore, little attention has been paid to the preservation of this structure [10]. However, studies on histology [6,[11][12][13][14], manometry [14][15][16][17][18][19][20][21], electromyography [14], anal endosonography [19,[21][22][23][24][25][26], magnetic resonance imaging [26,27], and computed tomography [27][28][29] have shown that IAS in ARMs is situated in the region of the fistulous bowel termination and the ectopic anus. It has been reported that RAIR presented in the low, intermediate, and high ARMs postoperatively in the manometric findings [11,18,[30][31][32].…”

Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management

“…Ultrasonography provides reliable information on the structural integrity of anal sphincters and the presence of faeces in the rectum. Endosonographic appearance of the normal anal canal has been well‐documented in children . Endosonography in children with functional constipation and associated FI has revealed significant thickening of the internal anal sphincter .…”