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Related Experiment Videos

[Computed tomography and anorectal malformations. Their postoperative evaluation].

P Fondelli1, A Taccone, G Martucciello

  • 1Servizio di Radiologia, Diagnostica per Immagini, Istituto G, Gaslini, Genova-Quarto GE.

La Radiologia Medica
|April 1, 1989
PubMed
Summary

Postoperative CT scans help identify causes of fecal incontinence after anorectal malformation surgery. This imaging guides surgical decisions to improve continence in children.

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Hirschsprung's disease, one of the most difficult diagnoses in pediatric surgery: a review of the problems from clinical practice to the bench.

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Area of Science:

  • Pediatric Surgery
  • Radiology
  • Gastroenterology

Background:

  • Fecal incontinence is a common postsurgical complication of anorectal malformation (ARM) treatment.
  • Key causes include malpositioned neo-rectum, poor sphincter development, and sacral anomalies.
  • Accurate postoperative assessment is crucial for planning corrective surgeries.

Purpose of the Study:

  • To evaluate the utility of postoperative computed tomography (CT) in assessing patients with fecal incontinence post-ARM surgery.
  • To correlate CT findings with the degree of fecal continence.
  • To determine if CT can guide the selection of appropriate surgical techniques for improving continence.

Main Methods:

  • Pelvic postoperative CT scans were performed on nine patients (aged 3-13 years) who underwent ARM surgery.

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  • Patients were categorized based on their degree of fecal continence (good, low, complete incontinence).
  • CT findings, including neo-rectum placement and sphincter development, were analyzed and correlated with clinical outcomes.

    • Main Results:

    • Good continence correlated with well-developed sphincters and correct neo-rectum placement.
    • Low continence was associated with correct neo-rectum placement but hypoplastic puborectal muscle.
    • Complete incontinence was linked to malpositioned neo-rectum and poor sphincter development.

    Conclusions:

    • Postoperative CT is a valuable tool for evaluating the anatomical factors contributing to fecal incontinence after ARM surgery.
    • CT findings aid in identifying candidates suitable for revision surgery, such as posterior sagittal anorectoplasty.
    • This imaging modality assists in selecting the optimal surgical strategy to enhance fecal continence.