Abstract
Background/Purpose: Fecal incontinence and constipation are common problems in follow-up of anorectal malformations (ARMs). We evaluated the anal sphincters using the 3-dimensional endoanal ultrasonography (3D-EAUS) and the anorectal manometry after ARMs repair. Methods: Seventeen patients, divided into 3 groups according to Wingspread classification, underwent anorectal manometry and 3D-EAUS. Clinical, manometric, and endosonographic scoring systems were used. Results: The average anal resting pressure (aARP) was significantly higher in low ARMs than in intermediate and high ARMs. The anal squeeze pressure was not statistically different between the 3 groups. Three-dimensional EAUS visualized internal anal sphincter (IAS) disruptions in 7 of 17 patients and absence of IAS in 6 of 17 children with high ARMs. Scars of the external anal sphincter were localized in low ARMs and generalized in the other groups. In the case of IAS disruption with aARP greater than 20 mm Hg, fecal incontinence and constipation improved with biofeedback and/or laxatives, whereas daily enemas were necessary in absence of IAS with aARP less than 20 mm Hg. Statistical correlation was observed between endosonographic and manometric findings and clinical outcomes. Conclusions: Lesions of the anal sphincter are common in ARMs. Three-dimensional EAUS and anorectal manometry ensure a complete assessment of the anal sphincter and could provide useful information to define the most appropriate treatments to improve the quality of life.
| Original language | English |
|---|---|
| Pages (from-to) | 956-963 |
| Number of pages | 8 |
| Journal | Journal of Pediatric Surgery |
| Volume | 47 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2012 |
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Keywords
- Anorectal malformations
- Anorectal manometry
- Constipation
- Endoanal ultrasonography
- Fecal incontinence
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
Three-dimensional endoanal ultrasound and anorectal manometry in children with anorectal malformations : New discoveries. / Caldaro, Tamara; Romeo, Erminia; De Angelis, Paola; Gambitta, Rosa Alba; Rea, Francesca; Torroni, Filippo; Foschia, Francesca; Federici Di Abriola, Giovanni; Dall'Oglio, Luigi.
In: Journal of Pediatric Surgery, Vol. 47, No. 5, 05.2012, p. 956-963.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Three-dimensional endoanal ultrasound and anorectal manometry in children with anorectal malformations
T2 - New discoveries
AU - Caldaro, Tamara
AU - Romeo, Erminia
AU - De Angelis, Paola
AU - Gambitta, Rosa Alba
AU - Rea, Francesca
AU - Torroni, Filippo
AU - Foschia, Francesca
AU - Federici Di Abriola, Giovanni
AU - Dall'Oglio, Luigi
PY - 2012/5
Y1 - 2012/5
N2 - Background/Purpose: Fecal incontinence and constipation are common problems in follow-up of anorectal malformations (ARMs). We evaluated the anal sphincters using the 3-dimensional endoanal ultrasonography (3D-EAUS) and the anorectal manometry after ARMs repair. Methods: Seventeen patients, divided into 3 groups according to Wingspread classification, underwent anorectal manometry and 3D-EAUS. Clinical, manometric, and endosonographic scoring systems were used. Results: The average anal resting pressure (aARP) was significantly higher in low ARMs than in intermediate and high ARMs. The anal squeeze pressure was not statistically different between the 3 groups. Three-dimensional EAUS visualized internal anal sphincter (IAS) disruptions in 7 of 17 patients and absence of IAS in 6 of 17 children with high ARMs. Scars of the external anal sphincter were localized in low ARMs and generalized in the other groups. In the case of IAS disruption with aARP greater than 20 mm Hg, fecal incontinence and constipation improved with biofeedback and/or laxatives, whereas daily enemas were necessary in absence of IAS with aARP less than 20 mm Hg. Statistical correlation was observed between endosonographic and manometric findings and clinical outcomes. Conclusions: Lesions of the anal sphincter are common in ARMs. Three-dimensional EAUS and anorectal manometry ensure a complete assessment of the anal sphincter and could provide useful information to define the most appropriate treatments to improve the quality of life.
AB - Background/Purpose: Fecal incontinence and constipation are common problems in follow-up of anorectal malformations (ARMs). We evaluated the anal sphincters using the 3-dimensional endoanal ultrasonography (3D-EAUS) and the anorectal manometry after ARMs repair. Methods: Seventeen patients, divided into 3 groups according to Wingspread classification, underwent anorectal manometry and 3D-EAUS. Clinical, manometric, and endosonographic scoring systems were used. Results: The average anal resting pressure (aARP) was significantly higher in low ARMs than in intermediate and high ARMs. The anal squeeze pressure was not statistically different between the 3 groups. Three-dimensional EAUS visualized internal anal sphincter (IAS) disruptions in 7 of 17 patients and absence of IAS in 6 of 17 children with high ARMs. Scars of the external anal sphincter were localized in low ARMs and generalized in the other groups. In the case of IAS disruption with aARP greater than 20 mm Hg, fecal incontinence and constipation improved with biofeedback and/or laxatives, whereas daily enemas were necessary in absence of IAS with aARP less than 20 mm Hg. Statistical correlation was observed between endosonographic and manometric findings and clinical outcomes. Conclusions: Lesions of the anal sphincter are common in ARMs. Three-dimensional EAUS and anorectal manometry ensure a complete assessment of the anal sphincter and could provide useful information to define the most appropriate treatments to improve the quality of life.
KW - Anorectal malformations
KW - Anorectal manometry
KW - Constipation
KW - Endoanal ultrasonography
KW - Fecal incontinence
UR - http://www.scopus.com/inward/record.url?scp=84861168557&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861168557&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2012.01.051
DO - 10.1016/j.jpedsurg.2012.01.051
M3 - Article
C2 - 22595581
AN - SCOPUS:84861168557
VL - 47
SP - 956
EP - 963
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 5
ER -