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Hans P. Haber - One of the best experts on this subject based on the ideXlab platform.
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Ultrasonography of Imperforate Anus in neonate: an approach correlated with current surgical concepts.
Ultraschall in Der Medizin, 2008Co-Authors: Hans P. HaberAbstract:Neonates with an Imperforate Anus pose a challenge to those responsible for diagnosing and treating the congenital abnormality. Early assessment and accurate diagnosis of the type of Imperforate Anus are essential for determining the appropriate surgical procedure. Transperineal ultrasonography (US) can be used to identify the internal fistula and to define the type of Imperforate Anus. Thus, US represents an useful noninvasive imaging modality for assisting in the diagnosis and appropriate management of this disease. We will describe this imaging technique and present different types of illustrative scans of an Imperforate Anus.
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Transperineal Sonography for Determination of the Type of Imperforate Anus
AJR. American journal of roentgenology, 2007Co-Authors: Hans P. Haber, Guido Seitz, Steven W. Warmann, Jörg FuchsAbstract:OBJECTIVE. The purpose of this study was to assess whether transperineal sonography is valid and accurate for discriminating the low (translevator) type of Imperforate Anus from the intermediate and high (supralevator) types. The distinction is critical in determination of the surgical approach.MATERIALS AND METHODS. Fifty-six consecutively enrolled infants (0–90 days old) with Imperforate Anus underwent transperineal gray-scale sonography with a 12-MHz linear array transducer. The distance between the distal rectal pouch and the perineum was measured, and a cutoff distance for differentiating types of Imperforate Anus was identified. The sonographic findings were compared with the final diagnosis reached with radiographic and surgical findings.RESULTS. Transperineal sonography was feasible in all children without specific preparation. The mean distance between the distal rectal pouch and the perineum in the 22 infants with low Imperforate Anus was 10 ± 4 (SD) mm compared with a mean of 24 ± 6 mm in the 3...
Jörg Fuchs - One of the best experts on this subject based on the ideXlab platform.
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Transperineal Sonography for Determination of the Type of Imperforate Anus
AJR. American journal of roentgenology, 2007Co-Authors: Hans P. Haber, Guido Seitz, Steven W. Warmann, Jörg FuchsAbstract:OBJECTIVE. The purpose of this study was to assess whether transperineal sonography is valid and accurate for discriminating the low (translevator) type of Imperforate Anus from the intermediate and high (supralevator) types. The distinction is critical in determination of the surgical approach.MATERIALS AND METHODS. Fifty-six consecutively enrolled infants (0–90 days old) with Imperforate Anus underwent transperineal gray-scale sonography with a 12-MHz linear array transducer. The distance between the distal rectal pouch and the perineum was measured, and a cutoff distance for differentiating types of Imperforate Anus was identified. The sonographic findings were compared with the final diagnosis reached with radiographic and surgical findings.RESULTS. Transperineal sonography was feasible in all children without specific preparation. The mean distance between the distal rectal pouch and the perineum in the 22 infants with low Imperforate Anus was 10 ± 4 (SD) mm compared with a mean of 24 ± 6 mm in the 3...
Woo Sun Kim - One of the best experts on this subject based on the ideXlab platform.
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Imperforate Anus: US Determination of the Type with Infracoccygeal Approach
Radiology, 2003Co-Authors: Tae Il Han, In-one Kim, Woo Sun KimAbstract:PURPOSE: To assess the usefulness of infracoccygeal transperineal ultrasonography (US) in differentiation between high- and low-type Imperforate Anus. MATERIALS AND METHODS: Infracoccygeal US was prospectively performed with a 7–10-MHz linear-array transducer prior to corrective surgery in 14 neonates with Imperforate Anus. The approach site was just inferior to the coccyx and posterior to the Anus. Transverse images of the anorectal area were obtained. The puborectalis muscle was identified, and the relationship between the puborectalis muscle and the distal rectal pouch was evaluated. US findings were compared with surgical findings. RESULTS: In 10 neonates, a low-type Imperforate Anus was correctly diagnosed at infracoccygeal US. In those with low-type Imperforate Anus, the puborectalis muscle was seen as a hypoechoic U-shaped band (n = 10), and the distal rectal pouch passed through the puborectalis muscle (n = 10). In four neonates with high-type Imperforate Anus, the puborectalis muscle was not iden...
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Transperineal ultrasonography in Imperforate Anus: identification of the internal fistula.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2000Co-Authors: In-one Kim, Tae Il Han, Woo Sun Kim, Kyung Mo YeonAbstract:The purpose of this study was to assess the usefulness of transperineal ultrasonography in identifying the internal fistula in cases of Imperforate Anus. Transperineal ultrasonography was performed in 19 infants (13 neonates and 6 older infants; 13 were male and 6 were female) with Imperforate Anus to identify the internal fistula. Sagittal plane images were obtained through the anal dimple, and the internal connection of the rectal fistula was traced. The ultrasonographically traced internal fistula was compared with that observed on distal loopography after colostomy or with surgical findings. The internal fistula was identified as a hypoechoic linear tract, containing linear echogenicity in some cases. Of 19 patients, internal fistulas were correctly identified in 16 patients; these were rectourethral (n = 12), rectovaginal (n = 1), rectovestibular (n = 1), rectovesical (n = 1), and rectocloacal (n = 1). In three patients, internal fistulas were incorrectly defined; these cases consisted of rectovestibular (n = 2) and rectovaginal (n = 1) fistulas. Internal fistulas were correctly identified in all of the 13 male patients and in 3 of 6 female patients. Transperineal ultrasonography is an excellent diagnostic modality to define the type of the internal fistula in Imperforate Anus.
Vilho Hiilesmaa - One of the best experts on this subject based on the ideXlab platform.
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first trimester diagnosis of Imperforate Anus
Ultrasound in Obstetrics & Gynecology, 2005Co-Authors: P. Taipale, L. Rovamo, Vilho HiilesmaaAbstract:Imperforate Anus or anorectal atresia is often associated with major fetal structural defects but it may also be an isolated abnormality. Prenatal diagnosis is difficult but may be assisted by ultrasound detection of a dilated distal bowel or rectum. We report on a fetus at 12 weeks of gestation in which a dilated colon was detected at ultrasound examination. Dilatation of the colon was clearly seen in the first and third trimesters of pregnancy, but was difficult to detect in the second trimester. At birth, the newborn was diagnosed with a low type of Imperforate Anus.
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First‐trimester diagnosis of Imperforate Anus
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2005Co-Authors: P. Taipale, L. Rovamo, Vilho HiilesmaaAbstract:Imperforate Anus or anorectal atresia is often associated with major fetal structural defects but it may also be an isolated abnormality. Prenatal diagnosis is difficult but may be assisted by ultrasound detection of a dilated distal bowel or rectum. We report on a fetus at 12 weeks of gestation in which a dilated colon was detected at ultrasound examination. Dilatation of the colon was clearly seen in the first and third trimesters of pregnancy, but was difficult to detect in the second trimester. At birth, the newborn was diagnosed with a low type of Imperforate Anus.
J W Brock - One of the best experts on this subject based on the ideXlab platform.
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Genital malformations and coexistent urinary tract or spinal anomalies in patients with Imperforate Anus.
The Journal of urology, 1997Co-Authors: J C Metts, L Kotkin, S Kasper, Y Shyr, M C Adams, J W BrockAbstract:Urinary tract malformations have been described in up to 50% of patients with Imperforate Anus but genital anomalies have been less well analyzed in the same patient population. We sought to evaluate the frequency of coexisting genital, urinary and spinal malformations in a population with Imperforate Anus. We reviewed 128 cases of Imperforate Anus, focusing on genital malformations and their relationship to anomalies of the urinary tract and spine. The series included 69 boys and 59 girls with low (59), intermediate (22) and high (47) Imperforate Anus. Boys were much more likely to have a genital or upper urinary tract problem than girls (26 or 50 versus 5 or 30%, respectively). The risk for both sets of problems increased with the level of the anorectal lesion. The incidence of genital malformations increased from 14 to 26% in the presence of a renal lesion and from 10 to 23% with an associated spinal problem. Conversely, the incidence of urinary and spinal anomalies increased in patients with genital malformations. The genitalia of children with Imperforate Anus should be carefully examined. Patients with anorectal malformations should also be evaluated for urinary tract and spinal problems. The yield of such studies increases in patients with recognized genital malformations.
