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Les défects sphinctériens anaux en endosonographie

Endosonography of anal sphincter disruptions

  • La Pathologie Anorectale
  • Published:
Acta Endoscopica

Résumé

Initialement destinée à explorer la prostate, l'échographie endocavitaire a été progressivement modifiée pour l'étude du tube digestif. Elle a notamment connu un essor considérable en protologie ces dix dernières années car cette technique anodine, simple à réaliser, peu coûteuse, fournit une excellente image anatomique du canal anal. Elle a éclairé la pathogénie de l'incontinence anale et occupe désormais une place prépondérante au sein du bilan de cette affection, la mise en évidence des défects sphinctériens ayant en effet un impact thérapeutique indéniable. Toutefois, il faut souligner que certaines images posent des problèmes d'interprétation non négligeables incitant à la prudence dans les décisions thérapeutiques.

«Les rayons X ne se trompent janais. C'est nous qui nous trompons en interprétant mal leur langage ou en leur demandant plus qu'ils ne peuvent nous donner.»

Summary

Initially devoted to explore the prostate, the intraluminal ultrasonography has progressively been adapted for the survey of the digestive tract. During these last ten years, it made great strides especially in proctology because the technique is insignificant, easy to achieve, low cost and provides an excellent anatomical picture of the anal canal. This method enlightened the pathogenesis of the anal incontinence and has taken a predominant place henceforth within the evaluation of this affection, providing an evidence of sphincter disruptions having in fact an undeniable therapeutic impact. Nevertheless, some images remain difficult to interpret correctly and the therapeutic decision must still be careful.

«The X-rays are never wrong. It is us who make mistakes when badly interpreting their language or when asking them more than what they can provide».

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Abbreviations

EEA :

échographie endo-anale

IA :

incontinence anale

IRM :

imagerie par résonance magnétique

PR :

sangle puborectale

SE :

sphincter externe

SI :

sphincter interne

AE :

anal endosonography

AI :

anal incontinence

MRI :

magnetic resonance imagery

PR :

puborectalis

ES :

external sphincter

IS :

internal sphincter

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  1. Service de Proctologie Médico-chirurgicale, Hôpital des Diaconesses, 18, rue du Sergent Bauchat, 75012, Paris, (France)

    V. De Parades, Isabelle Etienney & P. Atienza

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  1. V. De Parades
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  2. Isabelle Etienney
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  3. P. Atienza
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De Parades, V., Etienney, I. & Atienza, P. Les défects sphinctériens anaux en endosonographie. Acta Endosc 32, 15–29 (2002). https://doi.org/10.1007/BF03018026

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  • DOI: https://doi.org/10.1007/BF03018026

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