EVALUATION OF SACRAL RATIO AS A PROGNOSTIC FACTOR IN PATIENTS WITH ANORECTAL MALFORMATIONS

Correlation between sacral ratio and bowel function as well as fecal continence has been well documented in patients with anorectal malformations (ARMs). One hundred and twenty children with ARMs were investigated in this study. Sacral ratio (SR) was measured from pelvic X-rays of patients. Among th...

Full description

Bibliographic Details
Main Authors: J. Ahmadi, A. Kajbafzadeh, M. Kalantari, M. Nahvi, A. Hadipoor, B. Ashjaei V. Mehrabi
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2005-04-01
Series:Acta Medica Iranica
Subjects:
Online Access:https://acta.tums.ac.ir/index.php/acta/article/view/2980
_version_ 1819013208581603328
author J. Ahmadi
A. Kajbafzadeh
M. Kalantari
M. Nahvi
A. Hadipoor
B. Ashjaei V. Mehrabi
author_facet J. Ahmadi
A. Kajbafzadeh
M. Kalantari
M. Nahvi
A. Hadipoor
B. Ashjaei V. Mehrabi
author_sort J. Ahmadi
collection DOAJ
description Correlation between sacral ratio and bowel function as well as fecal continence has been well documented in patients with anorectal malformations (ARMs). One hundred and twenty children with ARMs were investigated in this study. Sacral ratio (SR) was measured from pelvic X-rays of patients. Among these, 52 patients (43%) had no pelvic X-ray and were excluded from this study. SR was measured by drawing three horizontal lines, through iliac crests (A), tip of coccyx (B) and inferior point of sacroiliac joints (C). The SR was determined by dividing the distance between lines B and C to the distance between lines A and B. In the normal and well developed children, the average ratio is ≥0.74. The SR was higher than 0.70 in 12 (17.7%) children and less than 0.69 in 56 children (82.3%). Among children with ARMs and abnormal SR, 38 cases (68%) had SR of 0.50-0.69; 12 cases (21.5%)had SR of 0.40-0.49 and 6 cases (10.5%) had SR of 0-0.39. In children with ARMs and normal SR, the fecal incontinence was observed in 2 cases (16%). In contrast, 16 cases (29%) with ARMs and abnormal SR had functional disturbance, either fecal incontinence or soiling (P < 0.12). When the patients had an absent sacrum, they had zero possibility for bowel control and frequently had major urinary problems. The sacral feature and SR appear to have a direct influence on the final functional outcome in ARMs. The abnormal SR < 0.7 correlates with poor bowel function. In patients with ARMs, sacral segment and SR are important factors in post operative bowel function disturbance.
first_indexed 2024-12-21T01:56:18Z
format Article
id doaj.art-9a1181baeb954bb4a81f72c170f91b8a
institution Directory Open Access Journal
issn 0044-6025
1735-9694
language English
last_indexed 2024-12-21T01:56:18Z
publishDate 2005-04-01
publisher Tehran University of Medical Sciences
record_format Article
series Acta Medica Iranica
spelling doaj.art-9a1181baeb954bb4a81f72c170f91b8a2022-12-21T19:19:46ZengTehran University of Medical SciencesActa Medica Iranica0044-60251735-96942005-04-01432EVALUATION OF SACRAL RATIO AS A PROGNOSTIC FACTOR IN PATIENTS WITH ANORECTAL MALFORMATIONS J. Ahmadi0 A. Kajbafzadeh1 M. Kalantari2 M. Nahvi3 A. Hadipoor4 B. Ashjaei V. Mehrabi5 Correlation between sacral ratio and bowel function as well as fecal continence has been well documented in patients with anorectal malformations (ARMs). One hundred and twenty children with ARMs were investigated in this study. Sacral ratio (SR) was measured from pelvic X-rays of patients. Among these, 52 patients (43%) had no pelvic X-ray and were excluded from this study. SR was measured by drawing three horizontal lines, through iliac crests (A), tip of coccyx (B) and inferior point of sacroiliac joints (C). The SR was determined by dividing the distance between lines B and C to the distance between lines A and B. In the normal and well developed children, the average ratio is ≥0.74. The SR was higher than 0.70 in 12 (17.7%) children and less than 0.69 in 56 children (82.3%). Among children with ARMs and abnormal SR, 38 cases (68%) had SR of 0.50-0.69; 12 cases (21.5%)had SR of 0.40-0.49 and 6 cases (10.5%) had SR of 0-0.39. In children with ARMs and normal SR, the fecal incontinence was observed in 2 cases (16%). In contrast, 16 cases (29%) with ARMs and abnormal SR had functional disturbance, either fecal incontinence or soiling (P < 0.12). When the patients had an absent sacrum, they had zero possibility for bowel control and frequently had major urinary problems. The sacral feature and SR appear to have a direct influence on the final functional outcome in ARMs. The abnormal SR < 0.7 correlates with poor bowel function. In patients with ARMs, sacral segment and SR are important factors in post operative bowel function disturbance.https://acta.tums.ac.ir/index.php/acta/article/view/2980Anorectal malformationssacral ratioincontinence
spellingShingle J. Ahmadi
A. Kajbafzadeh
M. Kalantari
M. Nahvi
A. Hadipoor
B. Ashjaei V. Mehrabi
EVALUATION OF SACRAL RATIO AS A PROGNOSTIC FACTOR IN PATIENTS WITH ANORECTAL MALFORMATIONS
Acta Medica Iranica
Anorectal malformations
sacral ratio
incontinence
title EVALUATION OF SACRAL RATIO AS A PROGNOSTIC FACTOR IN PATIENTS WITH ANORECTAL MALFORMATIONS
title_full EVALUATION OF SACRAL RATIO AS A PROGNOSTIC FACTOR IN PATIENTS WITH ANORECTAL MALFORMATIONS
title_fullStr EVALUATION OF SACRAL RATIO AS A PROGNOSTIC FACTOR IN PATIENTS WITH ANORECTAL MALFORMATIONS
title_full_unstemmed EVALUATION OF SACRAL RATIO AS A PROGNOSTIC FACTOR IN PATIENTS WITH ANORECTAL MALFORMATIONS
title_short EVALUATION OF SACRAL RATIO AS A PROGNOSTIC FACTOR IN PATIENTS WITH ANORECTAL MALFORMATIONS
title_sort evaluation of sacral ratio as a prognostic factor in patients with anorectal malformations
topic Anorectal malformations
sacral ratio
incontinence
url https://acta.tums.ac.ir/index.php/acta/article/view/2980
work_keys_str_mv AT jahmadi evaluationofsacralratioasaprognosticfactorinpatientswithanorectalmalformations
AT akajbafzadeh evaluationofsacralratioasaprognosticfactorinpatientswithanorectalmalformations
AT mkalantari evaluationofsacralratioasaprognosticfactorinpatientswithanorectalmalformations
AT mnahvi evaluationofsacralratioasaprognosticfactorinpatientswithanorectalmalformations
AT ahadipoor evaluationofsacralratioasaprognosticfactorinpatientswithanorectalmalformations
AT bashjaeivmehrabi evaluationofsacralratioasaprognosticfactorinpatientswithanorectalmalformations