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Content provided by Jon Lund
Clinical Associate Professor, School of Graduate Entry Medicine & Health, University of Nottingham
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Endoanal Ultrasound
Contents
- Description
- Indications
- Procedure
1. Description
Endoanal ultrasound is a significant advancement in the investigation of anorectal disorders and has become a central part in the management of faecal incontinence. It is a variation of endorectal ultrasound except the transducer, which is normally contained within a balloon for endorectal ultrasound, has been replaced by a cone. A 5cm depth is visualised with the ultrasound probe allowing the internal, external and puboretalis muscles to be visualised and it also provides a 360o cross-sectional view of the sphincters. In this way abnormalities of these structures can be easily detected.
2. Indications
- Faecal incontinence
- Main indication for endoanal ultrasound
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Faecal incontinence, caused by damage to the sphincters can be due to trauma, obstetric or operative complications, can easily be assessed. This is essential to differentiate these causes from primary degeneration of the internal sphincter for subsequent management plans
- Anal sepsis
- Can detect abscesses, collections and fistulous tracks.
Malignancy
- Can be used for pre-operative staging + follow up of anal neoplasms
- Depth and penetration of tumour can be visualised
- Perineal/anal pain
3. Procedure
- Simple to perform
- Men should be placed in the left lateral position
- Women should be placed in the lithotomy or prone positions as the left lateral position does not give adequate views of the anterior wall which is where high quality views are required for the detection of obstetric tears
- Cone is inserted with sufficient gel to give adequate lubrication and contact
- A series of images are collected from puborectalis, external and internal sphincters.
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