Ultrasound of the distal pouch in infants with imperforate anus

Donaldson, James S.; Black, Charles T.; Reynolds, Marleta; Sherman, Joseph; Shkolnik, Arnold

doi:10.1016/s0022-3468(89)80403-8

Cited by 43 publications

(47 citation statements)

References 8 publications

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“…Various radiological modalities have been used to determine the level of the distal pouch in infants with IA. The modalities include inverted lateral radiography (invertography), distal colostography (loopography), US, CT and MRI (1, 4, 7-11). The role of the use of a preoperative radiological modality for IA is to determine the level of the distal rectal pouch, to identify the presence and location of internal fistulas and to diagnose any associated anomalies.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, differentiation of low-type and high-type IAs with the use of US had been indirectly performed by measurement of the distance between the distal rectal pouch and the perineum (1, 4). However, the use of this method has been limited by measurement overlaps between high and low-type IAs and with variable cut-off points among studies.…”

Section: Discussionmentioning

confidence: 99%

“…Of the various preoperative modalities, transperineal ultrasonography (US) has been used to determine the IA type and to search for an associated internal fistula (1-4). Previously, the differentiation of a low-type from a high-type IA had been performed indirectly by measuring the distance from the distal rectal pouch to the perineum (1, 4).…”

mentioning

confidence: 99%

“…Previously, the differentiation of a low-type from a high-type IA had been performed indirectly by measuring the distance from the distal rectal pouch to the perineum (1, 4). However, recent improvement in US resolution has facilitated the identification and determination of location of internal fistulas with the use of transperineal US (3).…”

mentioning

confidence: 99%

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Imperforate Anus: Determination of Type Using Transperineal Ultrasonography

et al. 2009

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ObjectiveThis study was designed to assess the usefulness of transperineal ultrasonography (US) for the determination of imperforate anus (IA) type.Materials and MethodsFrom January 2000 to December 2004, 46 of 193 patients with an IA underwent transperineal US prior to corrective surgery. Sonographic findings were reviewed to identify the presence of internal fistulas and to determine "distal rectal pouch to perineum (P-P)" distances. IA types were determined based on the sonographic findings, and the diagnostic accuracy of transperineal US was evaluated based on surgical findings.ResultsOf the 46 patients, 17 patients were surgically confirmed as having a high-type IA, three patients were confirmed as having an intermediate-type IA and 26 patients were confirmed as having a low-type IA. The IA type was correctly diagnosed by the use of transperineal US in 39 of the 46 patients (85%). In 14 of the 17 patients with a high-type IA, internal fistulas were correctly identified. All cases with a P-P distance > 16 mm were high-type IAs and all cases with a P-P distance < 5 mm were low-type IAs.ConclusionTransperineal US is a good diagnostic modality for the identification of internal fistulas in cases of high-type IA and for defining the IA level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Imperforate Anus: Determination of Type Using Transperineal Ultrasonography

et al. 2009

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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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Transperineal versus transvaginal color Doppler imaging of the uterine circulation

Chan

Chau

Pun

et al. 1997

J. Clin. Ultrasound

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Transperineal sonography has been described as being useful in assessing patients in special clinical situations such as posterior placenta previa, preterm labor, stress incontinence, and vaginal atresia. We explored the feasibility of this approach in assessing the uterine circulation in 54 subjects, of whom 36 were postmenopausal. We found that visualization of the uterine artery by the transperineal approach was satisfactory in most patients. The uterine arterial Doppler indices obtained from this approach were compared with those obtained by the transvaginal route. Highly significant correlations were found (correlation coefficient r for pulsatility index = 0.74, p < 0.0001). No significant differences in results between the two approaches were detected using the Wilcoxon Matched‐Pairs Signed‐Rank test. We conclude that transperineal Doppler studies of the uterine circulation are possible and may be useful in certain patient groups. © 1997 John Wiley & Sons, Inc. J Clin Ultrasound 25:293–299, 1997

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Ultrasound of the distal pouch in infants with imperforate anus

Cited by 43 publications

References 8 publications

Imperforate Anus: Determination of Type Using Transperineal Ultrasonography

Imperforate Anus: Determination of Type Using Transperineal Ultrasonography

Congenital Anomalies of the Small Intestine, Colon, and Rectum

Transperineal versus transvaginal color Doppler imaging of the uterine circulation

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