MRI following PSARP in Children with Anorectal Malformations: Differences that Matter!
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2017, Vol 2, Issue 4
Abstract
Introduction: Anorectal malformations are a complex group of congenital anomalies affecting rectum, anus and also the urogenital tract in a significant number of patients. A number of imaging studies are performed as a part of preoperative assessment and planning for but postoperative MRI may play a key role in finding out the anatomical differences and analyzing the desired and actual surgical outcome. Objective: To study the MRI findings in children with anorectal malformation (ARM) after surgical repair (3 months after repair) and compare the differences from normal. Material and methods: Pelvic MRI studies of 20 ARM patients after surgical repair (3 months after all stages of repair completed) were analyzed to determine the location and volume of the neorectum, anorectal angle, anal stenosis, presence of peritoneal fat herniation, status of the puborectalis sling and pelvic floor muscles and other associated urinary tract and vertebral column abnormality. Findings were compared with those of normal children undergoing MRI for unrelated complaints. Results: Children with incontinence were more likely to have an increased anorectal angle while children with constipation have increased rectosigmoid volume. Puborectalis sling and pelvic floor muscles were thin in almost all patients with high ARM. Lower cord anomalies, lower sacral agenesis and neurogenic bladder are also a frequent association. Conclusions MRI is a helpful imaging modality in postoperative ARM patients and it shows distinct differences even postoperatively from normal children which may affect the desired surgical outcome. Thus MRI may act as a guide for further management and rehabilitation of these children
Authors and Affiliations
Shagufta Wahab, Tushar Zambaulikar Balkrishna, Rizwan Ahmad Khan, Ibne Ahmad
Keywords
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