1992 Volume 28 Issue 5 Pages 973-977
The Wangensteen-Rice invertography has often been used to judge the level of the rectal blind pouch of an imperforate anus in newborn infants. This modality, however, possibly can lead a misdiagnosis on the pouch level when the swallowed gas does not descend to the distal-most part of the blind bowel. Two newborn babies with low defect were erroneously considered as high defect by the invertography due to an impacted meconium in the blind pouch and an excessive contraction of the puborectal muscle complex. While, 4 infants were accurately evaluated the pouch levels by a real-time ultrasonography using 5 -MHz mechanical sector scanner. Two of them were exactly diagnosed as low defect with the distance between the pouch level and the perineal surface (P-P distance) measuring 5 mm each by ultrasonography, and the remaining 2 were high defect with the P-P distance measuring 19mm and 30mm, respectively. Real-time ultrasonography with small scanner can provide a non-invasive and accurate method to determine the site of the distal-most rectal pouch in babies with imperforate anus shortly after birth. Ultrasonography should be performed with the invertography for the level diagnosis of an imperforate anus in newborn infants.
