TY - JOUR ID - TI - Radiological Assessment of Anorectal Malformations; The Role of Transperineal and Infracoccgeal Sonography in Male Type Imperforate Anus AU - Zainab Kadhim Saeed, Waad Mohammed Salih PY - 2020 VL - 19 IS - 4 SP - 287 EP - 296 JO - Iraqi Postgraduate Medical Journal المجلة العراقية للاختصاصات الطبية SN - 83601608 98932708 AB - BACKGROUND:Anorectal malformation is a complex spectrum of anomalies. There are different types of anorectalmalformation. The distinction can usually be made on the basis of clinical data regarding thepresence or absence of a visible perineal opening or passage of meconium through the vagina orurethra.OBJECTIVE:To assess the validity of ultrasonography in detection of the exact anomaly in male type imperforateanus, in order to help plan the proper surgical approach.PATIENTS AND METHODS:A prospective study carried out between December 2017 and December 2018, at pediatric surgerydepartment in Central Teaching Hospital in Baghdad, Iraq. Nineteen patients with imperforate anuswere enrolled in this study (all were males), their age ranged between 1 day and 6 months. Allpatients were sent for trans-perineal ultrasound and infracoccgeal ultrasound, which were performedby using a high-resolution 11 MHz linear array transducer, in which the rectal pouch-perinealdistance(P-P distance), presence or absence of recto-urinary fistula along with its précised locationand the relation of the blind rectal-pouch to the pubo-rectalis muscle were obtained for a properclassification of the type of imperforate anus.US findings were compared to the operative findingswhich were the gold standard.RESULTS:The rectal pouch-perineal distance(P-P) was identified using US in all patients with a mean(27.3211) mm and SD +- (14.78631) mm. The puborectalis muscle was identified as a hypoechoicU-shaped band in all patients along with its relation to the blind rectal-pouch. There is a statisticallyhigh significant relationship between the US and the operative findings regarding the presence andprecise location of the internal fistula (P-value=0.0001).US findings showed a high sensitivity of92.8%, specificity of 100% and accuracy of 94.7%.CONCLUSION:US whether in (Transperineal Infracoccygeal) approach is highly accurate, it provides an excellentimaging modality with high sensitivity and specificity in the detection of the internal fistula. USmeasurements are independent of age.

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