title: [Evaluation of sphincter damage degree with anal endosonography for children with fecal incontinence].
abstract: OBJECTIVE
  To evaluate the application of anal endosonography in the morphology of internal anal sphincter (IAS), external anal sphincter (EAS) and puborectalis (PR) in order to provide necessary information for analysis of the etiology of fecal incontinence and formulation of the therapeutic schedule.
  
  
  METHODS
  From December 2010 to November 2012, 18 children of anorectal malformation (n=14) or Hirschsprung's disease(n=4) with fecal incontinence received anal endosonography. The morphology of IAS, EAS and PR was observed. The damage of anal sphincter was classified according to Starck criteria. Anorectal mamometry and anal clinical score were measured simultaneously. Spearman analysis was performed to examine the correlation of anal sphincter damage with anorectal mamometric score and anal clinical score.
  
  
  RESULTS
  According to Starck criteria, anal sphincter damage was small in 11 children, moderate in 6, and severe in 1. PR damage was found in 4 cases. Starck score was positively correlated with manometric score(P<0.05), while not correlated with anal clinical score(P>0.05).
  
  
  CONCLUSIONS
  Anal endosonography can clearly display the morphology of IAS, EAS and PR, and their integrity and damage degree. It is a very valuable technique to evaluate the anal sphincter of the children with fecal incontinence, which however can not reflect the function of anal sphincter and anal continence thoroughly.
authors.affiliation: Department of Pediatric Surgery, The Second Hospital of Shandong University, Jinan 250033, China. sunxiaobing.phd@163.com.
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Sun
authors.forename: Dianguo
authors.initials: D
authors.lastname: Li
authors.forename: Ruoyi
authors.initials: R
authors.lastname: Wang
authors.forename: Xiaogang
authors.initials: X
authors.lastname: Sun
authors.forename: Qian
authors.initials: Q
authors.lastname: Liu
mesh_terms: D001003:Anal Canal / Q000000981:diagnostic imaging*; D002648:Child; D019160:Endosonography; D005242:Fecal Incontinence / Q000000981:diagnostic imaging*; D006801:Humans; D008365:Manometry