By Giulio Aniello Santoro
New three-d endoanal and endorectal ultrasonographic and magnetic resonance imaging strategies have given higher perception into the advanced anatomy of the pelvic ground and its pathologic amendment in benign anorectal ailments. Obstetrical occasions resulting in fecal incontinence in women, the connection among fistulous tracks and the sphincter advanced, and mechanisms of obstructed defecation syndrome can now be appropriately evaluated, that is of basic significance for choice making. due to advancements within the prognosis of those issues, new different types of remedy were constructed with greater end result for sufferers. This ebook is aimed toward basic and colorectal surgeons, radiologists, gastroenterologists and gynecologists with a different curiosity during this box. it's also proper to every body who desires to increase their knowing of the basic rules of pelvic flooring problems.
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Additional info for Benign Anorectal Diseases: Diagnosis with Endoanal and Endorectal Ultrasound and New Treatment Options
Internal anal sphincter: hypoechoic (Fig. 14). The sphincter is not completely symmetric, either in thickness or termination (Fig. 15). In older age groups, the sphincter becomes thicker and loses its uniform lowlevel echogenicity, which is characteristic of smooth muscle throughout the gut, to become more echogenic and inhomogeneous in texture [3, 13] (Fig. 16). Although it seems normal and without lesions, sometimes the IAS has differences in echogenicity and thickness. Recently, an increasing interest in IAS degeneration has occurred.
The methods agreed in 88% of cases for primary fistula tracts, in 90% for location of the internal opening, in 78% for secondary tracts, and in 88% for fluid collection. 29 Fig. 26. Computer-generated three-dimensional (3-D) model of anal canal, rectum, prostate, pelvis, bladder, and spine based on 3-D endorectal ultrasonography data Recently, the group of Bartram conducted a prospective study to compare the accuracy of 3-D endoanal ultrasound with that of hydrogen-peroxide-enhanced 3-D endoanal ultrasound in diagnosing fistula-in-ano in 19 patients .
According to these studies, the anus is fundamentally a four-layer structure (Fig. 12) [3, 4, 12–17]. From inner to outer, these are: 1. Subepithelial tissues: moderately reflective. The mucosa as well the level of dentate line is not visualized. The muscularis submucosae ani can be sonographically identified in the upper part of the anal canal as a low reflective band (Fig. 13). 2. Internal anal sphincter: hypoechoic (Fig. 14). The sphincter is not completely symmetric, either in thickness or termination (Fig.
Benign Anorectal Diseases: Diagnosis with Endoanal and Endorectal Ultrasound and New Treatment Options by Giulio Aniello Santoro