Nonfluoroscopic pressure colostography in the evaluation of genitourinary fistula of anorectal malformations: experience in a resource-poor environment.
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.


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).


CONCLUSIONS
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.
Abdulkadir
Adekunle Yisau
AY
Department of Radiology, Teaching Hospital, University of Ilorin, Ilorin, 2340001, Kwara State, Nigeria. akyisau@yahoo.com
Abdur-Rahman
Lukman Olajide
LO
Adesiyun
Olusola Morohunfade
OM
D001003:Anal Canal / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage; D005837:Genitalia, Male / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011312:Pressure; D011859:Radiography; D012007:Rectum / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D040841:Resource Allocation; D014548:Urinary Fistula / Q000000981:diagnostic imaging*; D014564:Urogenital Abnormalities / Q000000981:diagnostic imaging*
D003287:Contrast Media