please write the answer and your justification, correct answer will be submitted after 48 hrs

 

[size=20px]A 4 month female with anal stenosis presents for routine follow up. She has been serially dilated to a 13 Hegar, although symptoms of constipation persist. A Voiding cystourethrography (VCUG), renal ultrasound, spinal ultrasound, and ECHO in the NICU were normal. The next step in management would include:

 

A No additional evaluation required

 

B Anal manometry

 

C Suction rectal biopsy

 

D Open rectal biopsy

 

E MRI of pelvis[/size]

Edited October 11, 20206 yr by Admin

Anal Manometry to screen for possible associated Hirschprung's disease. It is the least invasive of the investigations relevant.

Open rectal biopsy is more accurate in diagnosing HS

Anal manometry

Pelvic MRI to exclude Presacral masse.

E: MRI pelvis, to exclude a presacral mass & cord thethering

E is correct to role out Currarino syndrome

correct answer

E MRI of pelvis

to asses for presence of presacral mass (Currarino syndrome)

click the following link for Currarino syndrome chart: https://pediatricsurgery.club/forum/main-forum/lounge/anorectal-malformations/481-currarino-syndrome

Spine US is advised until age of 6 months to exclude Presacral masse .