Assessment of continence after treatment for anorectal malformations. II Radiologic study
Tanaka, K.
Nihon Geka Hokan. Archiv für Japanische Chirurgie 49(3): 308-322
1980
ISSN/ISBN: 0003-9152 PMID: 7259401 Document Number: 166159
Correlation of the clinical and radiologic assessment of continence in subjects after surgery for anorectal anomalies was studied. Radiologic study of defecation was performed in 19 patients who were followed at least 1 yr after radical operation for imperforate anus and in 4 normal children. The child was examined in the horizontal lateral position without preliminary cleansing enema. An 18 French gauge rubber catheter introduced into the anal canal and a 50% Ba suspension varying between 30 and 50 ml was instilled. After the catheter was withdrawn, filling of the rectum and anal canal was observed on an image intensifier with television viewing. After the child had 20 ml of glycerin enema, he was told to defecate. The act of defecation was simultaneouly recorded by videotaping (SONY Videorecorder EV-315 X) and 35 mm camera. In visualizing mobility of the pelvic floor, 4 landmarks were used: the P,C,I and A points (P, pubis; C, coccyx; I, ischeal ossification point and A, the crossing point of the rectal contour and the anal canal). Ba filling of the anal canal; fecal impaction in the rectum; anorectal angle (anterior angulation); complete expulsion or not of the contrast; mobility of the pelvic floor (elongation of the PA distance) and fecal reflux to the colon were observed.