Rectal Perforation following High-Pressure Distal Colostogram

Brisighelli, Giulia; Lorentz, Liam; Pillay, Tanyia; Westgarth-Taylor, Christopher

doi:10.1055/s-0040-1709140

Cited by 3 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, increasing the pressure may increase the possibility of reopening the blocked fistula after colostomy, and it also increases the risk of intestinal perforation [ 12 , 20 ]. The reported incidence of bowel perforation is approximately 2% [ 12 , 22 ]. Although no cases occurred in our study, the risk of bowel perforation caused by high-pressure colostogram should still be considered.…”

Section: Discussionmentioning

confidence: 99%

Preoperative fistula diagnostics in male anorectal malformations after colostomy: a single-center experience

Bai,

Zhang,

Lin

2023

BMC Med Imaging

View full text Add to dashboard Cite

Background Accurate preoperative fistula diagnostics in male anorectal malformations (ARM) after colostomy are of great significance. We reviewed our institutional experiences and explored methods for improving the preoperative diagnostic accuracy of fistulas in males with ARMs after colostomy. Methods A retrospective analysis was performed on males with ARMs after colostomy admitted to our hospital from January 2015 to June 2022. All patients underwent magnetic resonance imaging (MRI) and high-pressure colostogram (HPC) before anorectal reconstruction. Patients with no fistula as diagnosed by both modalities underwent a voiding cystourethrogram (VCUG). General information, imaging results and surgical results were recorded. Results Sixty-nine males with ARMs after colostomy were included. Age at the time of examination was 52 ~ 213 days, and the median age was 89 days. The Krickenbeck classification according to surgical results included rectovesical fistula (n = 19), rectoprostatic fistula (n = 24), rectobulbar fistula (n = 19) and no fistula (n = 7). There was no significant difference in the diagnostic accuracy between MRI and HPC for different types of ARMs. For determining the location of the fistula, compared to surgery, HPC (76.8%, 53/69) performed significantly better than MRI (60.9%, 42/69) (p = 0.043). Sixteen patients diagnosed as having no fistula by MRI or HPC underwent a VCUG, and in 14 patients, the results were comfirmed. However, there were 2 cases of rectoprostatic fistula that were not correctly diagnosed. Conclusion High-pressure colostogram has greater accuracy than MRI in the diagnosis of fistula type in males with ARMs after colostomy. For patients diagnosed with no fistula by both methods, VCUG reduces the risk of false-negative exclusion, and rectoprostatic fistula should be considered during the operation.

show abstract

Section: Discussionmentioning

confidence: 99%

Preoperative fistula diagnostics in male anorectal malformations after colostomy: a single-center experience

Bai,

Zhang,

Lin

2023

BMC Med Imaging

View full text Add to dashboard Cite

show abstract

“…To improve pre-operative fistula diagnostics, it is important to ensure that high-pressure colostogram is performed according to the literature-described correct method [ 14 ]. High-pressure colostogram has apparent limitations as a diagnostic method due to its operator-dependent outcome which is compromised in low-volume centers; in addition it is a source of radiation and there is the risk of bowel perforation [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of pre-operative fistula diagnostics in anorectal malformations

et al. 2021

View full text Add to dashboard Cite

Background Surgical safety during posterior sagittal anorectal plasty (PSARP) for anorectal malformations (ARM) depends on accurate pre-operative fistula localization. This study aimed to evaluate accuracy of pre-operative fistula diagnostics. Methods Ethical approval was obtained. Diagnostic accuracy of pre-PSARP symptoms (stool in urine, urine in passive ostomy, urinary tract infection) and examination modalities (voiding cystourethrogram (VCUG), high-pressure colostogram, cystoscopy and ostomy endoscopy) were compared to final intra-operative ARM-type classification in all male neonates born with ARM without a perineal fistula treated at a tertiary pediatric surgery center during 2001–2020. Results The 38 included neonates underwent reconstruction surgery through PSARP with diverted ostomy. Thirty-one (82%) had a recto-urinary tract fistula and seven (18%) no fistula. Ostomy endoscopy yielded the highest diagnostic accuracy for fistula presence (22 correctly classified/24 examined cases; 92%), and pre-operative symptoms the lowest (21/38; 55%). For pre-operative fistula level determination, cystoscopy yielded the highest diagnostic accuracy (14/20; 70%), followed by colostogram (23/35; 66%), and VCUG (21/36; 58%). No modality proved to be statistically superior to any other. Conclusions Ostomy endoscopy has the highest diagnostic accuracy for fistula presence, and cystoscopy and high-pressure colostogram for fistula level determination. Correct pre-operative ARM-typing reached a maximum of 60–70%.

show abstract

Delayed Complication Due to Retained Contrast Following Augmented Pressure Distal Loop Colostogram in Anorectal Malformation

Jangid

Sharma

Chanchlani

et al. 2022

African Journal of Paediatric Surgery

View full text Add to dashboard Cite

Augmented-pressure distal loop colostogram (APDC) is the most important diagnostic investigation to delineate the detailed anatomy to plan the reparative management of anorectal malformations. APDC is generally considered safe, with a very low complication rate. Herein, we present an unreported complication of APDC, manifesting as acute abdomen, due to retained contrast in distal loop. The patient was managed with evacuation of retained contrast from distal loop. We recommend evacuating the contrast from the distal loop following APDC.

show abstract

Rectal Perforation following High-Pressure Distal Colostogram

Cited by 3 publications

References 5 publications

Preoperative fistula diagnostics in male anorectal malformations after colostomy: a single-center experience

Preoperative fistula diagnostics in male anorectal malformations after colostomy: a single-center experience

Accuracy of pre-operative fistula diagnostics in anorectal malformations

Delayed Complication Due to Retained Contrast Following Augmented Pressure Distal Loop Colostogram in Anorectal Malformation

Contact Info

Product

Resources

About