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- Title
Radiologic evaluation of uterovaginal abnormalities in girls with congenital pouch colon.
- Authors
Khan, Niyaz; Pant, Nitin; Gupta, Amit; Anand, Rama; Yadav, Partap; Chadha, Rajiv; Choudhury, Subhasis
- Abstract
Background/Purpose: The radiologic investigations of 25 girls with congenital pouch colon (CPC), managed over 17 years, were retrospectively reviewed. In 13 girls who form the study group, the investigations provided information about the anomalous uterovaginal (UV) anatomy and these findings were studied. Materials and Methods: Age at presentation was 2 months to 10 years. The subtypes of CPC were Type I (n = 2), Type II (n = 9), and not recorded (n = 2). All patients had a double vagina and a unicornuate uterus on each side in the pelvis. The radiologic studies, performed at varying periods after surgery, included an intravenous urogram (IVU) (n = 4), micturating cystourethrogram (MCU) (n = 3), distal ileostogram/colostogram (n = 6), and magnetic resonance imaging (MRI) (n = 7). Results: IVU and MCU showed retrograde filling of the vaginas with contrast during micturition with a small-capacity urinary bladder and a relatively open bladder neck. The two vaginas were quite apart, but symmetrical in appearance and position. A distal dye study showed filling of the colonic pouch, its terminal fistula, and the two vaginas in six patients. Opacification of the bladder was seen in 3/6 girls, including one girl with left-sided Grade IV vesicoureteral reflux. MRI (n = 7) showed a monocornuate uterus on each side in the pelvis. The upper vaginas on each side were apart, being widely apart (n = 5) and somewhat closer (n = 2). The lower vaginas were closer with an intervaginal septum. Other findings were a widely open bladder neck and urethra in two girls with urinary incontinence and visualization of the terminal fistula of the colonic pouch (n = 2). The lumbosacral spine was normal in all patients. Conclusions: In girls with CPC, retrograde reflux of contrast into the vaginas during a distal dye study or an IVU/MCU may provide useful details of the anatomy of the vaginas. An MRI scan is recommended as essential for comprehensive evaluation of the anomalous UV anatomy.
- Subjects
COLON abnormalities; DIAGNOSIS of uterine diseases; VAGINA abnormalities; VAGINAL diseases; UTERUS abnormalities; VAGINA; GENITOURINARY organ radiography; MAGNETIC resonance imaging; POSTOPERATIVE period; RESTORATIVE proctocolectomy; URINARY incontinence; URINATION; RETROSPECTIVE studies; ANATOMY; DIAGNOSIS
- Publication
Journal of Indian Association of Pediatric Surgeons, 2019, Vol 24, Issue 2, p104
- ISSN
0971-9261
- Publication type
Article
- DOI
10.4103/jiaps.JIAPS_33_18