By Giulio Aniello Santoro
New third-dimensional endoanal and endorectal ultrasonographic and magnetic resonance imaging thoughts have given larger 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 complicated, and mechanisms of obstructed defecation syndrome can now be correctly evaluated, that's of primary significance for choice making. because of advancements within the prognosis of those problems, new sorts of remedy were built with greater end result for patients.
This ebook is geared toward basic and colorectal surgeons, radiologists, gastroenterologists and gynecologists with a distinct curiosity during this box. it's also appropriate to each person who desires to enhance their realizing of the basic rules of pelvic ground problems.
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Extra info for Benign Anorectal Diseases Diagnosis with Endoanal and Endorectal Ultrasonography and New Treatment Options
However, it remains difficult to reliably measure this structure because of the lack of clear limits. Also, the proposed use of a finger introduced into the vagina as a landmark seems to be of poor benefit, altering its normal configuration due to the digital compression on the central perineum [24, 25]. Three-dimensional endosonography may provide accurate imaging of the perineal body in females and more accurate measurement (Fig. 26). The anococcygeal raphe is seen as a posterior hypoechoic triangle (Fig.
During the examination, a sequence of ultra- sonic images is acquired while the tissue is slightly compressed by the ultrasound probe . Using numerical analysis of image pairs for the acquired sequence, the tissue strain is calculated that represents the spatial elasticity distribution of a specific cross-section of the organ. However, the techniques mentioned above appear to be most valuable for pre- and postoperative evaluation of anorectal malignancy. The most promising new technique for the diagnosis of benign anorectal diseases, such as fistulas and sphincter tears, is three-dimensional (3-D) endorectal ultrasound.
The puboanalis (PA) rises from the medial border of the puborectalis (PR) ment derived from the endopelvic fascia, extends caudally as the conjoined longitudinal layer (CLL) between the external and internal anal sphincters and terminates at the anorectal junction [2–5] (Figs. 3 and 4). Its fibroelastic component permeating through the subcutaneous part of the external sphincter terminates in the perianal skin. Konerding et al. , however, failed to detect striated muscle fibers within the longitudinal muscle that was solely composed of smooth muscle cells and connective tissue.