Augmented Pressure Distal Colostogram.
Keywords:augmented pressure distal colostogram (APDC), ano rectal malformations(ARMs).
Background: Anorectal malformations (ARMs) represent a complex group of congenital anomalies resulting from abnormal development of the hindgut, allantois and Mullerian duct, leading to incomplete or partial urorectal septal malformations .
Patients and methods: This is a prospective study including sixty-five male patients with high ARMs who were admitted to the department of pediatric surgery in Children Welfare Teaching Hospital in Medical City Complex - Baghdad - Iraq ; during the period from April 2009 to November 2011 ; they were subjected to divided descending colostomy in the postnatal period ;Augmented-Pressure Distal Colostogram (APDC) was performed at a later age for demonstration of the level of rectal atresia and the presence of the recto-urinary fistulas which then were confirmed at operation. Objectives: The objective of this study is the accurate demonstration of the anatomy of the level of rectal atresia and any associated recto-urinary fistula by using APDC for optimal surgical management using APDC .
Results: Rectourinary fistulas were demonstrated in 52 patients (80%) by APDC technique and were confirmed at operation in each case. In the remaining 13 patients (20%), this technique failed to demonstrate a fistula, in 8 of them no fistula was identified during operation or thereafter , while in the remaining 5 patients fistulas were detected during operation .
Conclusion: The APDC readily demonstrated the level of the rectal atresia and the associated recto-urinary fistulas in the majority of the patients , providing a road map for definitive surgical repair of ARMs.
How to Cite
For all articles published in Journal of the Faculty of Medicine Baghdad, copyright is retained by the authors. Articles are licensed under an open access Creative Commons CC BY NC 4.0 license, meaning that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. These conditions allow for maximum use and exposure of the work, while ensuring that the authors receive proper rights.