Accuracy of Lateral Invertogram in diagnosing and classifying anorectal malformations

Authors

  • CC Nwokoro
  • BA Ayoade
  • BA Salami
  • OM Fatungase
  • AA Olatunji
  • EA Emmanuel

DOI:

https://doi.org/10.30442/ahr.0601-06-66

Keywords:

Accuracy, Anorectal malformations, Imperforate anus, Lateral Invertogram, Neonatal Intestinal Obstruction

Abstract

Background: The initial management of a new born baby with anorectal malformation could be made only after an accurate determination of the level of the anomaly. 

Objective: To determine the accuracy of lateral invertogram in diagnosing and classifying anorectal anomalies.

Methods: This was a retrospective study carried out between January 2003 and December 2013. The accuracy, sensitivity, and specificity of lateral invertogram in diagnosing and classifying anorectal malformations in the cases studied were determined.

Results: A total of 62 children with anorectal malformations patients were seen during the study period. The age range was 4 hours to 6 years. A total of 50 (80.6%) had lateral invertogram while only 39 films of lateral invertogram were available for analysis. A total of 22 patients had high anomalies while 12 patients had low anomalies. The accuracy of lateral invertogram in identifying anorectal anomaly was 100% and its ability to differentiate between high and low anomalies was 76.5%. The Sensitivity in identifying high anomalies was 59% while the specificity was 31.8%. The sensitivity in identifying low lying lesions was 66.5% while the specificity was 50%.

Conclusion: The accuracy, sensitivity, and specificity of lateral invertogramin diagnosing and classifying anorectal malformations were found to be satisfactory in the present study.

References

Levitt MA, Pena A. Anorectal malformations. Orphanet J Rare Dis. 2012; 2: 33.

James AO, Jay LG, Eric WF, Arnold GC, Anthony AC. Principles of paediatric surgery. 2nd edition London, Mosby 2004: 587-603.

Alberto P. Anorectal anomalies.In: Lewis S, Arnold GC (Editors). Rob and Smiths Operative surgery. Paediatrics. 5th edition London, 1995: 423-457.

Lukong CS, Ameh EA, Mshelbwala, Jabo BA, Gomna A, Akiniyi OT, et al. Management of anorectal malformations: changing trend over two decades in Zaria, Nigeria. Afr J Paediatr Surg 2011; 8: 19-22.

Leonor A, Blaise JM, Meuwly JY, Reto AM, Francois G. Anorectal malformations: Finding the pathway out of the labyrinth. Radiograph 2013; 33: 491-512.

Ajay NG, Vaibhav P. Anorectal malformations. J Indian Assoc PediatrSurg. 2015; 20: 10-15.

Thapa B, Basnet B, Pun MS. Thapa A. Management of Anorectal Malformations in a Tertiary Level Children's Hospital of Nepal. J Nepal Paediatr Soc 2013; 33: 196-200.

Bhatnagar S. Anorectal malformation. J Neonatal Surg 2015; 4(2): 25.

Gangopadhyay AN, Pandey V. Anorectal malformations. J Indian Assoc Pediatr Surg 2015; 20:10-15.

Andrea B, John B, Alberto P. Controversies in anorectal malformations. The Lancet Child Adolesc Health 2017; 1: 323-330.

Jamal SK, Osama MR, Mazeen OK, Abdulrahman RA, Moayed F. A collective review of cases with imperforate anus managed in a teaching hospital. Saudi J Health Sci 2012; 1: 122-125.

Moore SW, Sidler D, Hadley GP. Anorectal malformations in Africa. S Afr J Surg. 2005: 4: 174-175.

Akanksha N, Jayesh S, Raychaudhin C. Radiological investigations of imperforate anus. Arch Integrated Med 2017; 4: 13-16.

Horsirimanont S, Sangkhathan S, Utamakul P, Chetphaopan J, Patrapinyokul S. An appraisal of invertograms and distal colostograms in the management of anorectal malformations. J Med Assoc Thai 2004; 87: 497-502.

Carlos AR. Current Concepts in the management of anorectal malformations. Hamdem Med J 2018; 11: 100-104.

Pranshu B, Mahajan JK, Ajay K. Anorectal malformations in children. J Indian Assoc Pediatr Surg 2006; 11: 136-139.

Pena A. Anorectal malformations. Semin Pediatr Surg1995; 4: 35-47.

Bendeker N, Brodis E, Borgstein E, Heij HA. The hidden mortality of imperforate anus. Afr J Paediatr Surg 2013; 10: 302-306.

Sechin C, Shawn PM, Tony F. One hundred three consecutive patients with Anorectal malformations and their associated anomalies. Arch Pediatr Adolesc Med. 2001; 155: 587-591.

Narasimharao KL, Prasad GR, Katariya S, Yadav K, Mitra SK, Pathak IC. Prone Cross-Table Lateral View: An Alternative to the invertogram in imperforate anus. Am J Roentgenol1983; 140: 227-229.

Makanga M, Nititenganya F, Kakande I. Anorectal malformations at University Teaching Hospital of Butare in Rwanda: A review of 46 Operative cases. East Cent Afr J Surg2006; 12: 110-115.

Pena A. A surgical management of anorectal malformations: a unified concept. Pediatr Surg Int 1988; 3: 82-93.

Gama M, Tadesse A. Management of anorectal malformations: Experience from Ethiopia. Ann Afr Surg 2018; 15: 1-4.

Rintala RJ. Anorectal malformations-management and outcome. Semin Neonatol 1996; 1: 219-230.

Published

2020-03-28

Issue

Section

Original Research

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