Original Research

Imaging in anorectal malformations: What does the surgeon need to know?

Christopher Westgarth-Taylor, Tracy Lee Westgarth-Taylor, Richard Wood, Marc Levitt
South African Journal of Radiology | Vol 19, No 2 | a903 | DOI: https://doi.org/10.4102/sajr.v19i2.903 | © 2015 Christopher Westgarth-Taylor, Tracy Lee Westgarth-Taylor, Richard Wood, Marc Levitt | This work is licensed under CC Attribution 4.0
Submitted: 30 June 2015 | Published: 11 December 2015

About the author(s)

Christopher Westgarth-Taylor, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, South Africa
Tracy Lee Westgarth-Taylor, Parklane Radiology Department, Netcare Park Lane Hospital, South Africa
Richard Wood, Center for Colorectal and Pelvic Reconstruction, Nationwide Children’s Hospital, Columbus, United States
Marc Levitt, Center for Colorectal and Pelvic Reconstruction, Nationwide Children’s Hospital, Columbus, United States


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Abstract

Imaging is essential in the diagnosis, management, surgical planning and eventual outcome in patients with anorectal malformation (ARM). This article outlines the imaging that may be required and the information needed by the surgeon to attain the best possible surgical outcome. ARM encompasses a wide spectrum of congenital malformations relating to the distal rectum and anus as well as the urinary and or gynaecological systems. The malformations range from a relatively simple perineal fistula with the potential for an excellent functional outcome, to complex cloacal malformation that requires specialist care and intervention. Approximately half of these children will have associated abnormalies. In the first 24–48 hours of life, imaging is used to determine if any associated anomalies are severe enough to preclude an operation, and what operation will be required so that the child can grow as normally as possible. If a colostomy is done, pre-definitive repair imaging in the form of a high-pressure distal colostogram determines the surgical approach required to repair the malformation. In more complicated cases of cloacal malformation, advanced imaging in the form of MRI or 3D fluoroscopy is valuable. In the South African setting, 2D fluoroscopy with the surgeon present is adequate to help in planning for the surgical management. Communication between the radiologist and paediatric surgeon is essential to ensure that such patients have the best possible outcome.

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Crossref Citations

1. Overview of Anorectal Malformations in Africa
Taiwo A. Lawal
Frontiers in Surgery  vol: 6  year: 2019  
doi: 10.3389/fsurg.2019.00007