Internal fat prolapse from ischiorectal fossa masquerading as currarino syndrome
Md Mokarram Ali1, Amit Kumar1, Rashi Rashi1
1Department of Pediatric Surgery, AIIMS, Patna, Bihar, India.
Abstract:
Pelvic magnetic resonance imaging (MRI) is the latest addition to already existing tools for evaluation of anorectal malformation (ARM). It provides detailed information about pelvic floor musculature as well as position of rectal pouch. However, lack of knowledge about normal pelvic floor anatomy can lead to misinterpretation of pelvic MRI which can create confusion and change in approach for surgery. A 14-month-old male child with diagnosis of ARM was evaluated with pelvic MRI. There was finding of abnormal protrusion of fat through the ischiorectal fossa which was misinterpreted as Currarino syndrome which created confusion immediately before posterior sagittal anorectoplasty. Pelvic MRI is highly informative while evaluating a case of ARM. However, a detailed knowledge of pelvic floor anatomy is mandatory to avoid wrong interpretation and misdiagnosis.
Insights
Pelvic MRI aids anorectal malformation (ARM) evaluation, but anatomical knowledge is crucial. Misinterpreting pelvic MRI findings can lead to diagnostic errors and surgical confusion.
Area of Science:
- Pediatric Radiology
- Surgical Anatomy
Background:
- Pelvic MRI is a valuable tool for assessing anorectal malformation (ARM).
- It offers detailed insights into pelvic floor musculature and rectal pouch position.
Observation:
- A case involving a 14-month-old male with ARM evaluated via pelvic MRI is presented.
- An abnormal fat protrusion in the ischiorectal fossa was initially misinterpreted.
Findings:
- The misinterpretation of the pelvic MRI finding led to a potential misdiagnosis of Currarino syndrome.
- This diagnostic uncertainty occurred just before a planned posterior sagittal anorectoplasty.
Implications:
- Accurate interpretation of pelvic MRI in ARM cases requires comprehensive knowledge of normal pelvic floor anatomy.
- Avoiding misinterpretation is essential to prevent surgical confusion and ensure appropriate patient management.
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