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Anal Sphincter Defect and Fecal Incontinence

Anal sphincter defects can lead to fecal incontinence. The relationship between the extent of defect and continence is controversial. Magnetic resonance imaging (MRI) of the pelvis can assess anal sphincter defects. Transrectal ultrasonography (TRUS) is used to assess sphincter integrity in adults....

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Autores principales: Mansi, Sherief, Vaz, Karla, Santucci, Neha R., El-Chammas, Khalil, Graham, Kahleb, Rosen, Nelson G., Kaul, Ajay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158374/
https://www.ncbi.nlm.nih.gov/pubmed/37168467
http://dx.doi.org/10.1097/PG9.0000000000000254
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author Mansi, Sherief
Vaz, Karla
Santucci, Neha R.
El-Chammas, Khalil
Graham, Kahleb
Rosen, Nelson G.
Kaul, Ajay
author_facet Mansi, Sherief
Vaz, Karla
Santucci, Neha R.
El-Chammas, Khalil
Graham, Kahleb
Rosen, Nelson G.
Kaul, Ajay
author_sort Mansi, Sherief
collection PubMed
description Anal sphincter defects can lead to fecal incontinence. The relationship between the extent of defect and continence is controversial. Magnetic resonance imaging (MRI) of the pelvis can assess anal sphincter defects. Transrectal ultrasonography (TRUS) is used to assess sphincter integrity in adults. We present a 17-year-old male with history of sexual abuse, rectal prolapse, and fecal incontinence. MRI showed a small defect that did not explain his clinical presentation. TRUS identified more extensive defects which were not picked up by MRI. The patient had rectopexy, and his rectal prolapse and fecal incontinence resolved. TRUS was superior in identifying sphincter defects compared with MRI. Our case also highlights that continence is possible despite large sphincter defects in pediatric patients. This may reflect the compensatory mechanism of residual sphincter in the absence of the aggravating factors like rectal prolapse.
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spelling pubmed-101583742023-05-09 Anal Sphincter Defect and Fecal Incontinence Mansi, Sherief Vaz, Karla Santucci, Neha R. El-Chammas, Khalil Graham, Kahleb Rosen, Nelson G. Kaul, Ajay JPGN Rep Case Report Anal sphincter defects can lead to fecal incontinence. The relationship between the extent of defect and continence is controversial. Magnetic resonance imaging (MRI) of the pelvis can assess anal sphincter defects. Transrectal ultrasonography (TRUS) is used to assess sphincter integrity in adults. We present a 17-year-old male with history of sexual abuse, rectal prolapse, and fecal incontinence. MRI showed a small defect that did not explain his clinical presentation. TRUS identified more extensive defects which were not picked up by MRI. The patient had rectopexy, and his rectal prolapse and fecal incontinence resolved. TRUS was superior in identifying sphincter defects compared with MRI. Our case also highlights that continence is possible despite large sphincter defects in pediatric patients. This may reflect the compensatory mechanism of residual sphincter in the absence of the aggravating factors like rectal prolapse. Lippincott Williams & Wilkins, Inc. 2022-10-20 /pmc/articles/PMC10158374/ /pubmed/37168467 http://dx.doi.org/10.1097/PG9.0000000000000254 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Mansi, Sherief
Vaz, Karla
Santucci, Neha R.
El-Chammas, Khalil
Graham, Kahleb
Rosen, Nelson G.
Kaul, Ajay
Anal Sphincter Defect and Fecal Incontinence
title Anal Sphincter Defect and Fecal Incontinence
title_full Anal Sphincter Defect and Fecal Incontinence
title_fullStr Anal Sphincter Defect and Fecal Incontinence
title_full_unstemmed Anal Sphincter Defect and Fecal Incontinence
title_short Anal Sphincter Defect and Fecal Incontinence
title_sort anal sphincter defect and fecal incontinence
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158374/
https://www.ncbi.nlm.nih.gov/pubmed/37168467
http://dx.doi.org/10.1097/PG9.0000000000000254
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