Title

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

Document Type

Journal Article

Publication Date

2-1-2018

Journal

Pediatric Radiology

Volume

48

Issue

2

DOI

10.1007/s00247-017-3962-2

Keywords

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

Abstract

© 2017, Springer-Verlag GmbH Germany. 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.

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