Abstract
Introduction Anorectal malformations (ARM) affect 1 in 5,000 newborns with a wide range of defects.
In the absence of a visible fistula, the diagnosis and classification of ARM require
an augmented pressure distal colostogram. This procedure can be done after a diverting
colostomy has been performed and implies exposing the child to radiation. We hypothesized
that high-resolution transperineal ultrasound could correctly diagnose the type of
ARM, thus sparing radiation exposure.
Case Description Four full-term male newborns with ARM and no visible anal opening were referred to
our center for further management. A diverting descendostomy was performed in the
first 48 hours of life in all cases. Prior to the reconstructive surgery, we performed
a high-resolution transperineal ultrasound with 3D tomographic reconstruction of the
perineal region to assess the urethra, the rectum, and a possible fistula. Findings
were compared with a conventional augmented pressure distal colostogram. The image
acquisition was fast and did not cause any additional distress to the children.
Conclusion In all cases the results of the distal colostogram nicely correlated with the high-resolution
transperineal ultrasound with 3D tomographic reconstruction. In the future, we envision
a time when it can potentially replace the distal colostogram in preoperative assessment
of ARM with no distress and exposure to radiation.
Keywords
anorectal malformations - ultrasound - diagnostics - reconstructive surgery
