Martucciello G, Taccone A, Cheli M, Lonati L, Oddone M, Dodero P, Pelizza A, Jasonni V
Divisione di Chirurgia Pediatrica, Istituto Giannina Gaslini, Genova.
Radiol Med. 1991 Nov;82(5):635-7.
The study of anorectal malformations has considerably improved over the last years also thanks to the use of such diagnostic techniques as CT and MR imaging, which allow a better knowledge of perineal region anatomy and the demonstration of the development of sphincteric structures. The most important diagnostic phase for the identification of anorectal malformations consists in the detection of rectal fistulas. The authors report on their experience with barred water-soluble contrast enema in the study of anorectal anomalies. Over 2 years, 23 patients with anorectal malformations (10 males and 13 females) previously submitted to colostomy, were studied with this method. Fistulas were detected in 21 cases; in the extant 2 patients (both females affected with Down syndrome), no fistulas were detected, not even at surgery, which was posterior sagittal anorectoplasty according to Peña-De Vries. In our experience, the most frequent anomalies were recto-bulbo-urethral fistula in males and low recto-vaginal fistula in females. The authors suggest the use of this method as a routine diagnostic examination, because of its proven reliability.
在过去几年中，由于使用了CT和磁共振成像等诊断技术，肛管直肠畸形的研究有了显著进展，这些技术有助于更好地了解会阴区解剖结构，并展示括约肌结构的发育情况。识别肛管直肠畸形最重要的诊断阶段在于检测直肠瘘。作者报告了他们在肛管直肠畸形研究中使用钡剂水溶性造影灌肠的经验。在两年多的时间里，对23例曾接受结肠造口术的肛管直肠畸形患者（10例男性和13例女性）采用这种方法进行了研究。在21例中检测到瘘管；在其余2例患者（均为患有唐氏综合征的女性）中，即使在手术时（根据佩尼亚 - 德弗里斯法进行的后矢状位肛门直肠成形术）也未检测到瘘管。根据我们的经验，最常见的畸形在男性中是直肠 - 球部 - 尿道瘘，在女性中是低位直肠 - 阴道瘘。作者建议将这种方法作为常规诊断检查使用，因为其可靠性已得到证实。
