By M. Pescatori, C.I. Bartram, A.P. Zbar, R.J. Nicholls

2-D and 3D anal ultrasound are one of the latest and complicated instruments to be had for either the analysis and the administration of anorectal illnesses. they're neither dear nor destructive for the sufferers and steadily changed anal mapping with EMG electrodes for the prognosis of sphincter's defects and anismus, which represents approximately 50% of the circumstances of continual constipation. Anal US could provide the clinician with valuable details for either class, prognosis and administration of anorectal sepsis, anal incontinence and anorectal-perineal power ache. nearly any case provided during this Atlas exhibits either imaging and medical photographs, hence permitting either the radiologist and the clinician to evaluate the reliability of the examination and the end result of the chosen treatment.

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Additional info for Clinical Ultrasound in Benign Proctology: 2-D and 3-D Anal, Vaginal and Transperineal Techniques

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20a. 20b. Perianal abscess extent on different level sectioning of the anal canal M. Pescatori • S. Ayabaca • M. Spyrou • P. De Nardi Fig. 20c. Drainage of the abscess in this case Fig. 20d. End of operation with insertion of a Petzer catheter Fig. 20e. The catheter has been utilized to produce a postoperative sinogram to show the extent of the cavity and to direct the timing of catheter withdrawal Chapter 2 33 34 Chapter 2 Clinical Use of Two-Dimensional Endoanal and Transvaginal Sonography Recurrent Fistula Fig.

52. Left lateral internal sphincterotomy for anal fissure (markers) Fig. 54. Another case with internal sphincter thinner than normal with hypertone at anal manometry Fig. 53. Patient with a chronic anal fissure and a thin internal anal sphincter (markers). This patient had marked resting hypertonia on anal manometry justifying a formal internal anal sphincterotomy 54 Chapter 2 Clinical Use of Two-Dimensional Endoanal and Transvaginal Sonography Proctalgia Proctalgia may be accompanied by many other anal lesions such as deep-seated perianal sepsis, which are readily demonstrable on endoanal ultrasonography and which require treatment in their own right.

Sultan AH, Kamm MA, Hudson CN, Nicholls JR, Bartram CI (1994) Endosonography of the anal sphincters: normal anatomy and comparison with manometry. Clin Radiol 49:368-374 6. Sultan AH, Loder PB, Bartram CI, Kamm MA, Hudson CN (1994) Vaginal endosonography new approach to image the undisturbed anal sphincter. Dis Colon Rectum 37:1296-1299 7. Sandridge DA, Thorp JM Jr (1995) Vaginal endosonography in the assessment of the anorectum. Obstet Gynecol 86:1007-1009 8. Alexander AR, Liu J, Menton DA, Nagle DA (1996) Fecal incontinence: transvaginal ultrasound evaluation of anatomic causes.

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