Sonography of imperforate anus.

Oppenheimer, D A; Carroll, B A; Shochat, Stephen J.

doi:10.1148/radiology.148.1.6856821

Cited by 39 publications

(21 citation statements)

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“…This "M" line is used to classify lesions as high, intermediate, or low. US is useful in delineating the distance from the distal pouch to the perineum (56)(57)(58). A distance of less than 10 mm indicates a low lesion, which can be safely treated with simple perineal anoplasty; a distance greater than 15 mm indicates a lesion that requires diversion with colostomy.…”

Section: N Anorectal Anomaliesmentioning

confidence: 99%

Congenital Anomalies of the Small Intestine, Colon, and Rectum

Berrocal¹,

Lamas²,

Gutiérrez³

et al. 1999

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Congenital anomalies of the gastrointestinal tract are a significant cause of morbidity in children and, less frequently, in adults. These abnormalities include developmental obstructive defects of the small intestine, anomalies of the colon, anomalies of rotation and fixation, anorectal anomalies, and intestinal duplications. Neonates with complete high intestinal obstruction do not usually require further radiologic evaluation following radiography, whereas those with complete low obstruction should undergo a contrast material enema examination. An upper gastrointestinal series must be performed in all patients with incomplete intestinal obstruction because management is different in each case. In low intestinal obstruction, ultrasonography (US) may help differentiate between small bowel obstruction and colonic obstruction. In addition, US can help correctly identify meconium ileus and meconium peritonitis and is useful in the diagnosis of enteric duplication cysts. In malrotation and anorectal anomalies, computed tomography (CT) and magnetic resonance (MR) imaging can provide superb anatomic detail and added diagnostic specificity. Intestinal duplications manifest as an abdominal mass at radiography, contrast enema examination, or US. At CT, most duplications manifest as smoothly rounded, fluid-filled cysts or tubular structures with thin, slightly enhancing walls. At MR imaging, the intracystic fluid has heterogeneous signal intensity on T1-weighted images and homogeneous high signal intensity on T2-weighted images. Familiarity with these gastrointestinal abnormalities is essential for correct diagnosis and appropriate management.

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Section: N Anorectal Anomaliesmentioning

confidence: 99%

Congenital Anomalies of the Small Intestine, Colon, and Rectum

Berrocal¹,

Lamas²,

Gutiérrez³

et al. 1999

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197

129

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“…Transperineal US may be used to assess the level of a rectal atresia [40]. The puborectalis muscle is the landmark which has been used to define the level of atresia.…”

Section: Rectal Atresiamentioning

confidence: 99%

Ultrasound of the hollow gastrointestinal tract in children

Sj¹

1997

European Radiology

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IntroductionChildren are generally very suitable subjects for ultrasound (US) examinations. US is often the first investigation performed for suspected abdominal or pelvic pathology. It may precede radiographic examination and has many advantages. It is non-invasive, does not use ionising radiation and can be performed quickly and portably, if necessary. It is generally well tolerated by babies and children. Increasingly in paediatric practice US is used for investigating suspected disease of the hollow gastrointestinal (GI) tract. Improvements in US equipment, particularly the development of high-frequency linear-array transducers, have led to better visualisation of the GI tract by US. It is now possible to examine the bowel with transabdominal or transperineal US from the gastro-oesophageal junction to the rectum.Ultrasound, like other cross-sectional imaging techniques, primarily provides information about the bowel wall and masses related to the gut. Contrast studies and endoscopy are superior examinations for assessing the mucosa or lumen. However, unlike CT or MRI, US is also able to assess bowel motion. This may be particularly important in some paediatric GI conditions such as idiopathic hypertrophic pyloric stenosis, congenital gut dysmotility and Hirschprung's disease.The purpose of this review is to examine the current use of US of the hollow GI tract in children. Paediatric applications of newer developments in bowel US, such as endoscopic US and power-Doppler scanning, are also discussed. Normal bowelAll bowel has a similar wall composition comprising five concentric layers. These are the mucosa, deep mucosa, submucosa, muscularis propria (inner circular and outer longitudinal fibres) and the serosa or adventitia. Bowel wall constituents are visible on good-quality transabdominal US scans using high-frequency linear-array transducers.In adult patients high-quality images of bowel wall composition have been produced using endoscopic US [1]. It is possible to define the five layers of the bowel wall with this technique using frequencies of 7.5 and 12 MHz (Fig. 1). Transabdominal paediatric bowel US does not usually produce such clear internal detail of the gut wall (Fig. 2).There are no data in the literature on the normal range of US measurements of bowel wall thickness for children. Wall thickness is known to change with peristalsis. Published US measurements for bowel wall thickness in adults date from the early 1980's and are 3 and 5 mm for relaxed and contracted bowel, respectively [2]. Data are lacking on gut wall measurements in healthy children with modern US equipment. A recent study suggested that normal relaxed colon wall in children and adults was less than 0.8 mm thick [3]. TechniqueWe use 5-to 7-MHz curvilinear-array and 10.5-MHz linear-array transducers for paediatric bowel US. It is generally possible to use higher frequency US than in adult practice. These allow a study of both deep and superficial bowel loops. Fluid in bowel can facilitate the US examination. For example, administrat...

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“…All of these techniques are important for the evaluation of the functional anatomy of the pelvic floor [2] . TPUS was initially proposed for the examination of the anorectal region since 1983 in neonates with imperforate anus [3] and later, other studies have also described the importance of this examination for the assessment of this area [4] . This is a simple, accessible, inexpensive, safe and painless technique that dynamically and non invasively evaluates anorectal structures.…”

Section: Introductionmentioning

confidence: 99%

Current applications of transperineal ultrasound in gastroenterology

Albuquerque¹,

Pereira²

2016

WJR

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Transperineal ultrasound is an inexpensive, safe and painless technique that dynamically and noninvasively evaluates the anorectal area. It has multiple indications, mainly in urology, gynaecology, surgery and gastroenterology, with increased use in the last decade. It is performed with conventional probes, positioned directly above the anus, and may capture images of the anal canal, rectum, puborectalis muscle (posterior compartment), vagina, uterus, (central compartment), urethra and urinary bladder (anterior compartment). Evacuatory disorders and pelvic floor dysfunction, like rectoceles, enteroceles, rectoanal intussusception, pelvic floor dyssynergy can be diagnosed using this technique. It makes a dynamic evaluation of the interaction between pelvic viscera and pelvic floor musculature, with images obtained at rest, straining and sustained squeezing. This technique is an accurate examination for detecting, classifying and following of perianal inflammatory disease. It can also be used to sonographically guide drainage of deep pelvic abscesses, mainly in patients who cannot undergo conventional drainage. Transperineal ultrasound correctly evaluates sphincters in patients with fecal incontinence, postpartum and also following surgical repair of obstetric tears. There are also some studies referring to its role in anal stenosis, for the measurement of the anal cushions in haemorrhoids and in chronic anal pain. structures interaction during defecation stimulation manoeuvres, as well as the identification, classification, and follow-up in inflammatory perianal disease, and it can also identify sphincter injury in fecal incontinence. In this review the technique is described and the current evidence that supports its use in several areas is also discussed.Albuquerque A, Pereira E. Current applications of transperineal ultrasound in gastroenterology.

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Sonography of imperforate anus.

Cited by 39 publications

References 0 publications

Congenital Anomalies of the Small Intestine, Colon, and Rectum

Congenital Anomalies of the Small Intestine, Colon, and Rectum

Ultrasound of the hollow gastrointestinal tract in children

Current applications of transperineal ultrasound in gastroenterology

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