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 journalArticlepeer-review

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

Keywords

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

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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