Nonfluoroscopic pressure colostography in the evaluation of genitourinary fistula of anorectal malformations: Experience in a resource-poor environment
Department of Radiology, Teaching Hospital, University of Ilorin, Ilorin, Kwara State 2340001, Nigeria; Paediatric Surgery Unit, Teaching Hospital, University of Ilorin, Ilorin, Kwara State, Nigeria
Background: Radiological imaging is paramount for defining the genitourinary fistulae commonly associated with anorectal malformations prior to definitive surgery. The imaging options are resource-limited in many parts of the world. Nonfluoroscopic pressure colostography after colostomy is a cheap method for the evaluation of anorectal malformations. Objective: To describe our experience with nonfluoroscopic pressure colostography in the evaluation of anorectal malformations in boys. Materials and methods: The study included 12 boys with anorectal malformation who had colostomy and nonfluoroscopic pressure-augmented colostography with water-soluble contrast medium between January 2006 and December 2007. Results: Patient ages ranged from 2 days to 1 year. The types of genitourinary fistula were rectovesical (7.7%) and rectourethral (92.3%). Oblique radiographs were of diagnostic value in all patients. The types of anorectal malformations were high, intermediate and low in 75%, 8.3% and 16.7%, respectively. Short-segment urethral constriction was a common feature of rectourethral fistula (75%, n=9). Conclusion: Our experience has shown that genitourinary fistulae associated with anorectal malformations can be demonstrated reliably by nonfluoroscopic pressure colostography with two oblique radiographs, providing an option in resource-poor settings where fluoroscopic equipment is scarce. © 2008 Springer-Verlag.
diatrizoate; meglumine diatrizoate; anorectal malformation; article; bladder; clinical article; clinical feature; colostomy; controlled study; diagnostic imaging; genitourinary fistula; human; infant; male; newborn; nonfluoroscopic pressure colostography; priority journal; urethra stricture; urogenital tract malformation; Anal Canal; Contrast Media; Genitalia, Male; Humans; Image Enhancement; Infant; Infant, Newborn; Male; Pressure; Rectum; Resource Allocation; Urinary Fistula; Urogenital Abnormalities