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MRI findings in patients with defecatory dysfunction after surgical correction of anorectal malformation

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Abstract

Background

Postoperative anorectal malformation patients frequently have defecatory dysfunction. MRI may be useful in the management of these patients.

Objective

To analyze static and dynamic MRI findings in patients with defecatory dysfunction after correction of anorectal malformation (ARM), and compare differences between patients with constipation and fecal incontinence.

Materials and methods

Pelvic MRI studies of 20 constipated and 32 incontinent postoperative ARM patients were analyzed retrospectively to determine the location and morphology of the neorectum, presence of peritoneal fat herniation, presence of scarring, development of the striated muscle complex (SMC) and any other abnormalities. The two groups were then compared using χ 2-test. Eighteen patients also underwent MRI defecography to evaluate pelvic floor function and abnormalities are reported.

Results

The children with incontinence were more likely to have abnormal location of the neorectum (P = 0.031), increased anorectal angle (ARA) (P = 0.031) and peritoneal fat herniation (P = 0.032), and less likely to have dilation of the neorectum (P = 0.027), than the children with constipation. There were no significant differences between the two groups in incidence of focal stenosis of the neorectum (P = 0.797), presence of extensive scarring (P = 0.591) and developmental agenesis of the SMC (P > 0.05). MRI defecography showed 6 anterior rectoceles, 6 cystoceles and 18 pelvic floor descents.

Conclusions

MRI is a helpful imaging modality in postoperative ARM patients with defecatory dysfunction, and it shows distinct differences between the children with constipation and incontinence and provides individualized information to guide further treatment.

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Acknowledgments

This research supported by Natural Science Foundation of Shandong Province, NO. ZR2010HL055.

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiology, Second Hospital of Shandong University, Jinan, 250033, China

    Cui Yong & Shao Guang-rui

  2. Department of Pediatric Surgery, Second Hospital of Shandong University, Jinan, 25003, China

    Wang Ruo-yi

  3. Evidence-based Medical Center, Second Hospital of Shandong University, Jinan, 250033, China

    Zhang Yuan

  4. Department of Laboratory, Second Hospital of Shandong University, Jinan, 250033, China

    Zhang Shu-hui

Authors
  1. Cui Yong
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  2. Wang Ruo-yi
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  3. Zhang Yuan
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  4. Zhang Shu-hui
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  5. Shao Guang-rui
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Corresponding author

Correspondence to Shao Guang-rui.

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Yong, C., Ruo-yi, W., Yuan, Z. et al. MRI findings in patients with defecatory dysfunction after surgical correction of anorectal malformation. Pediatr Radiol 43, 964–970 (2013). https://doi.org/10.1007/s00247-013-2639-8

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  • DOI: https://doi.org/10.1007/s00247-013-2639-8

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