Comparison between the pouch-perineum distance in neonates with a low-type anorectal malformation with and without an opened fistula: Pitfall of measuring the pouch-perineum distance on sonography

Takahiro Hosokawa, Hiroaki Takahashi, Yutaka Tanami, Yumiko Sato, Yujiro Tanaka, Hiroshi Kawashima, Mayumi Hosokawa, Eiji Oguma, Yoshitake Yamada

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective—An anorectal malformation (ARM) in neonates requires urgent surgery, with the type of surgery being dependent on the type of malformation (low, intermediate, or high). Distal rectal pouch and perineum (pouch-perineum) distance is reported to be useful for differentiating the type of ARM; however, the impact of an opened fistula on pouch-perineum distance is not well known. The purpose of this study was to evaluate the difference in pouch-perineum distance between neonates with a low-type ARM with and without an opened fistula. Methods—We included 24 neonates with low-type ARM who underwent sonography before surgery. Eight neonates already had an opened fistula before sonography, and 16 did not. The pouch-perineum distance was measured using the perineal approach. Mann-Whitney U and Spearman’s correlation coefficient tests were used for statistical analysis. Results—The mean pouch-perineum distance in all neonates with a low-type ARM was 8.3 ± 2.9 mm. The pouch-perineum distance was substantially longer for an ARM with than without an opened fistula (10.6 ± 3.4 mm vs. 7.1 ± 1.7 mm; P =.02). No appreciable correlation was identified between the pouch-perineum distance and the postnatal day of examination (ρ =-.23, P =.26) or birth weight (ρ =.15, P =.47). Conclusion—The pouch-perineum distance is substantially longer in neonates with an ARM with an opened fistula than in those without an opened fistula. Caution should be exercised by the sonographic examiner in evaluating pouch-perineum distance in neonates with an opened fistula to prevent an incorrect surgical procedure based on misdiagnosis of the type of ARM.

Original languageEnglish
Pages (from-to)2797-2802
Number of pages6
JournalJournal of Ultrasound in Medicine
Volume37
Issue number12
DOIs
Publication statusPublished - 2018 Jan 1

Fingerprint

Perineum
Fistula
Ultrasonography
Anorectal Malformations
Diagnostic Errors
Birth Weight

Keywords

  • Anorectal malformation
  • Fistula
  • Imperforate anus
  • Newborn
  • Ultrasonography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Comparison between the pouch-perineum distance in neonates with a low-type anorectal malformation with and without an opened fistula : Pitfall of measuring the pouch-perineum distance on sonography. / Hosokawa, Takahiro; Takahashi, Hiroaki; Tanami, Yutaka; Sato, Yumiko; Tanaka, Yujiro; Kawashima, Hiroshi; Hosokawa, Mayumi; Oguma, Eiji; Yamada, Yoshitake.

In: Journal of Ultrasound in Medicine, Vol. 37, No. 12, 01.01.2018, p. 2797-2802.

Research output: Contribution to journalArticle

Hosokawa, Takahiro ; Takahashi, Hiroaki ; Tanami, Yutaka ; Sato, Yumiko ; Tanaka, Yujiro ; Kawashima, Hiroshi ; Hosokawa, Mayumi ; Oguma, Eiji ; Yamada, Yoshitake. / Comparison between the pouch-perineum distance in neonates with a low-type anorectal malformation with and without an opened fistula : Pitfall of measuring the pouch-perineum distance on sonography. In: Journal of Ultrasound in Medicine. 2018 ; Vol. 37, No. 12. pp. 2797-2802.
@article{a0adcc7a78114eea869ddf1bc7398968,
title = "Comparison between the pouch-perineum distance in neonates with a low-type anorectal malformation with and without an opened fistula: Pitfall of measuring the pouch-perineum distance on sonography",
abstract = "Objective—An anorectal malformation (ARM) in neonates requires urgent surgery, with the type of surgery being dependent on the type of malformation (low, intermediate, or high). Distal rectal pouch and perineum (pouch-perineum) distance is reported to be useful for differentiating the type of ARM; however, the impact of an opened fistula on pouch-perineum distance is not well known. The purpose of this study was to evaluate the difference in pouch-perineum distance between neonates with a low-type ARM with and without an opened fistula. Methods—We included 24 neonates with low-type ARM who underwent sonography before surgery. Eight neonates already had an opened fistula before sonography, and 16 did not. The pouch-perineum distance was measured using the perineal approach. Mann-Whitney U and Spearman’s correlation coefficient tests were used for statistical analysis. Results—The mean pouch-perineum distance in all neonates with a low-type ARM was 8.3 ± 2.9 mm. The pouch-perineum distance was substantially longer for an ARM with than without an opened fistula (10.6 ± 3.4 mm vs. 7.1 ± 1.7 mm; P =.02). No appreciable correlation was identified between the pouch-perineum distance and the postnatal day of examination (ρ =-.23, P =.26) or birth weight (ρ =.15, P =.47). Conclusion—The pouch-perineum distance is substantially longer in neonates with an ARM with an opened fistula than in those without an opened fistula. Caution should be exercised by the sonographic examiner in evaluating pouch-perineum distance in neonates with an opened fistula to prevent an incorrect surgical procedure based on misdiagnosis of the type of ARM.",
keywords = "Anorectal malformation, Fistula, Imperforate anus, Newborn, Ultrasonography",
author = "Takahiro Hosokawa and Hiroaki Takahashi and Yutaka Tanami and Yumiko Sato and Yujiro Tanaka and Hiroshi Kawashima and Mayumi Hosokawa and Eiji Oguma and Yoshitake Yamada",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/jum.14636",
language = "English",
volume = "37",
pages = "2797--2802",
journal = "Journal of Ultrasound in Medicine",
issn = "0278-4297",
publisher = "American Institute of Ultrasound in Medicine",
number = "12",

}

TY - JOUR

T1 - Comparison between the pouch-perineum distance in neonates with a low-type anorectal malformation with and without an opened fistula

T2 - Pitfall of measuring the pouch-perineum distance on sonography

AU - Hosokawa, Takahiro

AU - Takahashi, Hiroaki

AU - Tanami, Yutaka

AU - Sato, Yumiko

AU - Tanaka, Yujiro

AU - Kawashima, Hiroshi

AU - Hosokawa, Mayumi

AU - Oguma, Eiji

AU - Yamada, Yoshitake

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective—An anorectal malformation (ARM) in neonates requires urgent surgery, with the type of surgery being dependent on the type of malformation (low, intermediate, or high). Distal rectal pouch and perineum (pouch-perineum) distance is reported to be useful for differentiating the type of ARM; however, the impact of an opened fistula on pouch-perineum distance is not well known. The purpose of this study was to evaluate the difference in pouch-perineum distance between neonates with a low-type ARM with and without an opened fistula. Methods—We included 24 neonates with low-type ARM who underwent sonography before surgery. Eight neonates already had an opened fistula before sonography, and 16 did not. The pouch-perineum distance was measured using the perineal approach. Mann-Whitney U and Spearman’s correlation coefficient tests were used for statistical analysis. Results—The mean pouch-perineum distance in all neonates with a low-type ARM was 8.3 ± 2.9 mm. The pouch-perineum distance was substantially longer for an ARM with than without an opened fistula (10.6 ± 3.4 mm vs. 7.1 ± 1.7 mm; P =.02). No appreciable correlation was identified between the pouch-perineum distance and the postnatal day of examination (ρ =-.23, P =.26) or birth weight (ρ =.15, P =.47). Conclusion—The pouch-perineum distance is substantially longer in neonates with an ARM with an opened fistula than in those without an opened fistula. Caution should be exercised by the sonographic examiner in evaluating pouch-perineum distance in neonates with an opened fistula to prevent an incorrect surgical procedure based on misdiagnosis of the type of ARM.

AB - Objective—An anorectal malformation (ARM) in neonates requires urgent surgery, with the type of surgery being dependent on the type of malformation (low, intermediate, or high). Distal rectal pouch and perineum (pouch-perineum) distance is reported to be useful for differentiating the type of ARM; however, the impact of an opened fistula on pouch-perineum distance is not well known. The purpose of this study was to evaluate the difference in pouch-perineum distance between neonates with a low-type ARM with and without an opened fistula. Methods—We included 24 neonates with low-type ARM who underwent sonography before surgery. Eight neonates already had an opened fistula before sonography, and 16 did not. The pouch-perineum distance was measured using the perineal approach. Mann-Whitney U and Spearman’s correlation coefficient tests were used for statistical analysis. Results—The mean pouch-perineum distance in all neonates with a low-type ARM was 8.3 ± 2.9 mm. The pouch-perineum distance was substantially longer for an ARM with than without an opened fistula (10.6 ± 3.4 mm vs. 7.1 ± 1.7 mm; P =.02). No appreciable correlation was identified between the pouch-perineum distance and the postnatal day of examination (ρ =-.23, P =.26) or birth weight (ρ =.15, P =.47). Conclusion—The pouch-perineum distance is substantially longer in neonates with an ARM with an opened fistula than in those without an opened fistula. Caution should be exercised by the sonographic examiner in evaluating pouch-perineum distance in neonates with an opened fistula to prevent an incorrect surgical procedure based on misdiagnosis of the type of ARM.

KW - Anorectal malformation

KW - Fistula

KW - Imperforate anus

KW - Newborn

KW - Ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=85051779951&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85051779951&partnerID=8YFLogxK

U2 - 10.1002/jum.14636

DO - 10.1002/jum.14636

M3 - Article

C2 - 29629723

AN - SCOPUS:85051779951

VL - 37

SP - 2797

EP - 2802

JO - Journal of Ultrasound in Medicine

JF - Journal of Ultrasound in Medicine

SN - 0278-4297

IS - 12

ER -