AbouZeid Amr Abdelhamid, Mohammad Shaimaa Abdelsattar
Pediatric Surgery Department, Faculty of Medicine, Ain-Shams University.
Radiodiagnosis Department, Faculty of Medicine, Ain-Shams University.
J Pediatr Surg. 2016 Nov;51(11):1851-1858. doi: 10.1016/j.jpedsurg.2016.05.025. Epub 2016 Jun 6.
To define the degree of deviation from the norm among boys with minor forms of anorectal malformations (ARM).
Between March 2015 and January 2016, we studied the preoperative MRI of nine boys with low-type ARM. For comparison, we included another nine boys (control group) who underwent MRI pelvis for causes other than ARM (e.g. impalpable testes).
In boys with low-type ARM, the rectum descends forwards to touch the back of the prostate (as in the norm), but then goes downwards (with little or no backward deflection) keeping intimately attached to the bulb of the corpus spongiosum and displacing it downwards and forwards. The striated sphincter muscles do not follow the anterior displacement of the bowel termination, but remain orthotopically compacted at the normal predestined site of the anal canal.
Among boys with low ARM, the minor abnormalities at the external anal orifice are associated with deeper anatomical aberrations in the form of anterior misplacement of the anorectum. These findings may help in understanding the disturbed act of defecation among these patients, and provide guidance to the best way of surgical correction.
确定患有轻度肛门直肠畸形（ARM）的男孩与正常标准的偏差程度。
2015年3月至2016年1月期间，我们研究了9名低位型ARM男孩的术前磁共振成像（MRI）。作为对照，我们纳入了另外9名男孩（对照组），他们因ARM以外的原因（如睾丸未触及）接受了骨盆MRI检查。
在低位型ARM男孩中，直肠向前下降至触及前列腺后部（如正常情况），但随后向下走行（很少或没有向后偏转），并紧密附着于海绵体球部，使其向下和向前移位。横纹括约肌并不随肠管末端的向前移位而移动，而是在肛管正常预定位置原位紧密聚集。
在低位ARM男孩中，肛门外口的轻度异常与肛门直肠向前错位形式的更深层次解剖学畸变有关。这些发现可能有助于理解这些患者排便功能紊乱的情况，并为最佳手术矫正方式提供指导。
