Sriwijaya Journal of Surgery
Vol. 3 No. 2 (2020): Sriwijaya Journal of Surgery

Accuracy of Transperineal Sonography and Distal Loopogram in Determining Distal Rectal Pouch-Perineal Distance and Fistula on Anorectal Malformation Post Colostomy Patients in Dr. Mohammad Hoesin General Hospital Palembang

Halomoan Sejahtera (Department of Surgery, Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia)
Sindu Saksono (Department of Surgery, Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia)
Uli Hanna Marsinta (Department of Radiology, Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia)
Erial Bahar (Department of Anatomy Faculty of Medicine Sriwijaya University, Palembang, Indonesia)



Article Info

Publish Date
18 Nov 2020

Abstract

Background: Imperforated anus is a congenital abnormality which is better known as anorectal malformation. The incidence of anorectal malformations is 1 in 4000 to 5000 live births. The incidence of anorectal malformations in Europe varies from 1.14 to 5.96 per 10,000 people and can change each year.1-3 The surgical approach in the management of anorectal malformations depends on the classification of anorectal malformations based on low, intermediate and high location. The distal loopogram or distal colostrography / colostrogram examination is an examination that is very important to determine the location of the distal rectum before definitive repair, but this examination has the disadvantage of using contrast and x-ray radiation. One alternative radiological examination that can be used for faster initial management is sonographic.7 Methods: This study was a diagnostic test study to assess the diagnostic accuracy of the distal loopogram / colostrography examination and sonographic examination with the transperineal approachon post-colostomy Anorectal Malformations patients at Mohammad Hoesin Hospital, Palembang in August 2019-October 20120 or until the number of research samples is met. Results: There were 21 samples in this study, 11 (52.4%) samples were dominated by clinical appearance without fistula. On the results of ultrasound examination, the majority of samples of rectouretral fistulas were 7 (33.3%). Loopogram examination found the majority of samples without fistulas as many as 10 (47.6%) samples. On intraoperative examination, 7 (33.3%) samples were obtained for rectouretral fistulas. The result of pouch-perineum measurement on ultrasound examination was 1.15 ± 0.6 cm, loopogram was 0.7 ± 1.5 cm, intra-operasionem was 1.8 ± 1.6 cm. In this study, USG has a very high accuracy value with a sensitivity of 100% and a specificity of 93.8% while the Loopogram has a sensitivity of 100% and a specificity of 68.8%. Conclusion: Transperineal ultrasound has a very high accuracy value with a sensitivity of 100% and a specificity of 93.8% while the Loopogram has a sensitivity of 100% and a specificity of 68.8%. Although there is a significant difference between the distal rectum -perineal distance calculation with a difference of -0.38 ± 0.70 cm, these two methods are equally accurate in assessing the distal rectal pouch -perineal distance and the location of the fistula.

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Journal Info

Abbrev

sjs

Publisher

Subject

Medicine & Pharmacology

Description

SRIWIJAYA JOURNAL OF SURGERY Sriwijaya Journal of Surgery (SJS) is a peer-reviewed journal published twice a year (June and December) by Department of Surgery, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia. SJS is intended to be the journal for publishing articles reporting the ...