title: Study of pelvic floor and sphincter muscles in congenital pouch colon with the help of three-dimensional CT scan.
abstract: BACKGROUND
  Congenital pouch colon (CPC) is a pouch-like dilatation of shortened colon associated with anorectal malformation (ARM). The disease is prevalent in northern India. Postoperatively, the continence results are not as good as in other ARMs and there is higher incidence of incontinence and perineal soiling in these patients. The present study aimed to evaluate the pelvic floor and sphincter muscle characteristics in patients of CPC with the help of 64-slice computerized tomography with three-dimensional (3D) volumetric reconstructions of images, thus, to know the overall quality of these muscles in the patients.
  
  
  METHODS
  The study was conducted in patients admitted over a period of July 2007 to November 2008 in our department. Totally, eight patients of CPC were subjected to 64-slice CT with three-dimensional reconstructions of images and different parameters such as quality of pelvic floor muscles, configuration of vertical and parasagittal fibres, shape and thickness of sphincter muscle complex, attenuation values of sphincters were studied.
  
  
  RESULTS
  The 3D reconstructed images of pelvis in patients of CPC showed a well-developed pelvic floor and sphincter muscle complex. The length of the parasagittal fibres, transverse width of the vertical fibres and CT attenuation values of these structures with overall muscle quality were found to be good in these patients.
  
  
  CONCLUSIONS
  In cases of CPC, the pelvic floor muscles including striated muscle complex (vertical and parasagittal fibres) are well developed. Higher rates of incontinence and soiling in CPC are not because of poorly developed pelvic floor and sphincter muscles. Three-dimensional CT can also provide important anatomical information that can help the operating surgeon while performing surgery.
authors.affiliation: C.S.M.M.U., Lucknow, India. imaddym@gmail.com
authors.forename: Madhukar
authors.initials: M
authors.lastname: Maletha
authors.forename: S N
authors.initials: SN
authors.lastname: Kureel
authors.forename: Tanvir Roshan
authors.initials: TR
authors.lastname: Khan
authors.forename: Ashish
authors.initials: A
authors.lastname: Wakhlu
mesh_terms: D001003:Anal Canal / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D002648:Child; D003106:Colon / Q000002:abnormalities*; D004065:Digestive System Abnormalities / Q000000981:diagnostic imaging; D004108:Dilatation, Pathologic; D005242:Fecal Incontinence / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D007194:India; D007231:Infant, Newborn; D017773:Pelvic Floor / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed