[Computed tomography of the pelvis in pediatric proctology]

Area of Science:

• Medical Imaging
• Pediatric Surgery
• Anatomy

Background:

• Accurate assessment of the external sphincter of the anus (ESA) is crucial for managing anorectal anomalies and perineal injuries.
• Computed tomography (CT) offers detailed visualization of pelvic floor musculature.

Purpose of the Study:

• To evaluate the diagnostic capabilities of CT in delineating ESA topography in patients with anorectal anomalies.
• To assess the utility of CT in evaluating ESA injuries resulting from trauma and perineal rupture.

Main Methods:

• Retrospective analysis of CT scans from pediatric patients with anorectal anomalies.
• CT examination of patients with perineal trauma and sphincter rupture.

Main Results:

• CT accurately visualizes ESA muscle topography in anorectal malformations, noting ventral displacement of the puborectal sling in certain fistulas.
• The degree of ESA muscle development in anorectal anomalies does not consistently correlate with the level of atresia.
• CT identified pelvic floor dysplasia and specific anal sphincter anomalies as a fourth component in caudal anomalies.
• CT effectively determines the depth and extent of ESA muscle ruptures in perineal trauma.

Conclusions:

• CT is the preferred imaging modality for diagnosing anorectal anomalies in children, particularly for identifying presacral masses and sphincter abnormalities.
• CT provides precise assessment of ESA muscle integrity in cases of perineal trauma, guiding surgical intervention.