PMID: 15222518Jun 30, 2004Paper

An appraisal of invertograms and distal colostograms in the management of anorectal malformations

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
Suthas HorsirimanontSakda Patrapinyokul

Abstract

To determine the accuracy of two main radiologic tools currently employed in the clinical management of anorectal malformations, the invertogram and the distal colostogram. The data will be useful as a basis for quality assurance as well as for future comparisons in case there are innovations to be considered. Radiological materials and clinical records of infants with anorectal malformations operated on in Songklanagarind Hospital from 1995 to 2001 were retrieved. Each record was blindly reviewed by two radiologists and one pediatric surgeon. Using operative findings as the gold standard, the accuracy of an invertogram in diagnosing low anomalies and the accuracy of a distal colostogram in screening cases that needed a laparotomy and in detecting internal fistulas were determined. The quality of the films was also categorized and poor quality studies were excluded from the analysis. Cases of common cloaca were not included in the level reading analysis. Radiologic materials from 59 patients were examined, including 26 invertograms and 49 distal colostograms. Among 52 cases whose neonatal history could be traced, 29 (55.8%) cases exhibited clinical evidence of anomalies level. Two invertograms and 5 colostograms were graded as ...Continue Reading

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