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Pediatr Radiol. 2018 Feb;48(2):258-269. doi: 10.1007/s00247-017-3962-2. Epub 2017 Aug 24.

Augmented-pressure distal colostogram: the most important diagnostic tool for planning definitive surgical repair of anorectal malformations in boys.

Author information

1
Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA. steven.kraus@cchmc.org.
2
Departments of Radiology and Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. steven.kraus@cchmc.org.
3
Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, OH, USA.
4
Departments of Surgery and Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA.
5
International Center for Colorectal Care, Children's Hospital Colorado, Aurora, CO, USA.
6
Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.

Abstract

There is little current literature on the augmented-pressure distal colostogram, the single most important diagnostic study performed in boys with imperforate anus prior to definitive repair. Accurate understanding of the anatomy of the anorectal malformation including an associated fistulous communication between the rectum and the urogenital tract is essential for optimal surgical management. Specifically, the position of the rectal pouch and recto-urinary fistula relative to posterior sagittal structures of the perineum, especially the sacral spine, dictates the operative approach. This pictorial essay is a guide for those who encounter such children with relative infrequency to become more comfortable with the technique. We report how to perform this radiologic exam and the potential pitfalls from our experience of performing the technique in our large pediatric colorectal practice.

KEYWORDS:

Anorectal malformation; Children; Distal colostogram; Fluoroscopy; Imperforate anus; Recto-urinary fistula

PMID:
28840291
DOI:
10.1007/s00247-017-3962-2
[Indexed for MEDLINE]

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