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

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Abstract

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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Authors and Affiliations

  1. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA

    Steven J. Kraus

  2. Departments of Radiology and Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Steven J. Kraus

  3. Center for Colorectal and Pelvic Reconstruction, Nationwide Children’s Hospital, Columbus, OH, USA

    Marc A. Levitt

  4. Departments of Surgery and Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA

    Marc A. Levitt

  5. International Center for Colorectal Care, Children’s Hospital Colorado, Aurora, CO, USA

    Alberto Peña

  6. Department of Surgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA

    Alberto Peña

Authors
  1. Steven J. Kraus
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  2. Marc A. Levitt
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  3. Alberto Peña
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Correspondence to Steven J. Kraus.

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Kraus, S.J., Levitt, M.A. & Peña, A. Augmented-pressure distal colostogram: the most important diagnostic tool for planning definitive surgical repair of anorectal malformations in boys. Pediatr Radiol 48, 258–269 (2018). https://doi.org/10.1007/s00247-017-3962-2

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  • DOI: https://doi.org/10.1007/s00247-017-3962-2

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