THE STUDY OF FECAL INCONTINENCE IN POST-OPERATIVE ANORECTAL MALFORMATIONS – A CLINICAL CORRELATION WITH MRI FINDINGS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 11
Abstract
BACKGROUND Imaging studies done in the postoperative Anorectal Malformation patients serve for the evaluation of the associated malformations and for the assessment of the causes for fecal incontinence including the complications of surgery. The objective of the study was to assess status of fecal continence in postoperative Anorectal malformation by correlating clinical evaluation with Magnetic Resonance Imaging (MRI) findings and to compare Kelly’s score of continence with MRI scoring. MATERIALS AND METHODS The study includes 32 postoperative ARM patients, of three to fourteen years of age, who presented to Gandhi Medical College, Secunderabad over a period of 27 months. Children were clinically assessed for the continence by Kelly score and studied with MRI imaging for the location and morphology of neorectum, presence of scarring, presence of peritoneal fat herniation, development of the striated muscle complex and any other abnormalities. RESULTS Of the 32 patients, 10 cases presented with low, 20 with high and 2 patients with intermediate anorectal anomalies; 10 out of 32 patients (Low ARA-9, intermediate-1) following definitive surgery for anorectal malformations were assessed clinically as good, 7 (Intermediate ARA-1, low-1, high-5) were fair and 15 high ARA were poor. Sphincter muscle development was poor in 15 patients of high ARA, fair in 7 patients (Intermediate ARA-1, low-1, high-5) and good in 10 patients (Low-9, intermediate-1). On comparison of Kelly’s continence score with MRI scoring, children with poor clinical continence score coincided with the poor muscle development, fair with fair muscle development and cases with good continence score had good muscle development. Of the 32 patients, 19 had fecal incontinence and 13 were continent. Of the thirteen, 10 were low ARA, 2 were intermediate and 1 was high anorectal anomaly. CONCLUSION Kelly’s clinical continence score in post-operative ARM correlated well with MRI scoring of puborectalis and external sphincter measurement with good score coinciding with good muscle development.
Authors and Affiliations
Talari Kumar, Nagarjuna , Rajesh , Rajendra Prasad
Keywords
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- EP ID EP159557
- DOI 10.14260/jemds/2016/103
- Views 54
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