[Descending perineum syndrome in children: Pathophysiology and diagnosis]

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Diagnostic Imaging

Background:

• Descending perineum syndrome (DPS) is often diagnosed using complex methods.
• Accurate diagnosis is crucial for managing anorectal anomalies (AA) and functional constipation in children.

Purpose of the Study:

• To introduce a safer, simpler, and more precise diagnostic method for DPS.
• To evaluate puborectalis muscle dysfunction in pediatric patients.

Main Methods:

• A modified irrigoscopy technique using an X-ray CT contrast marker near the anus was employed.
• 194 patients (5 days to 15 years) were studied, including those with and without AA, functional constipation, and post-operative cases.
• The distance between the anorectal angle (ARA) and the marker was measured.

Main Results:

• The proposed method allows for a more exact estimation of DPS by assessing puborectalis muscle status.
• This technique can potentially replace defecography, reducing the need for more invasive procedures.
• Barium enema with minimal X-ray films decreases radiation exposure.

Conclusions:

• The modified irrigoscopy is a valuable tool for diagnosing DPS in children with various anorectal conditions.
• It offers a safer and more accurate alternative for pre- and post-operative assessment in pediatric patients.
• This method simplifies the diagnostic process and reduces radiation hazards.