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Original Articles
Benign bowel disease
Anal canal coronal-sagittal ratio: a novel parameter for diagnosing pelvic floor injury in 2-dimensional transanal ultrasound
Hong Yoon Jeong, Keehoon Hyun, Jong Kyun Lee
Ann Coloproctol. 2024;40(5):459-466.   Published online November 10, 2022
DOI: https://doi.org/10.3393/ac.2022.00129.0018
  • 3,540 View
  • 96 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Purpose
Pelvic floor injury diagnosis using 3-dimensional (3D) pelvic floor ultrasound or magnetic resonance imaging is unfeasible in many clinics. We assessed the efficacy of a novel diagnostic parameter, the anal canal coronal-sagittal (CS) ratio, for pelvic floor injury on 2D transanal ultrasound.
Methods
This retrospective study analyzed the data of 126 female patients who underwent 3D pelvic floor ultrasound (including 2D transanal ultrasound) at a pelvic floor center between August and December 2020. The anal canal CS ratio on 2D transanal ultrasound and pelvic floor avulsion injury measurements were recorded for all patients.
Results
A cutoff anal canal CS ratio of 1.15 was obtained using receiver operating characteristic analysis (sensitivity, 0.820; specificity, 0.763; and area under the curve, 0.838). Patients were categorized into the anal canal CS ratio ≥1.15 and the anal canal CS ratio <1.15 groups. Bilateral pelvic floor avulsion was more common in the anal canal CS ratio ≥1.15 group (n=35, 56.5%), and the incidence of pelvic floor avulsion was significantly different between the 2 groups (P=0.001). Existing parameters of pelvic floor injury, including minimal levator hiatus (P=0.001), levator plate descent angle (P=0.001), and levator ani deficiency score (P=0.001), were statistically different between the 2 groups.
Conclusion
The anal canal CS ratio was an efficient novel parameter that indirectly detected pelvic floor injury in 2D transanal ultrasound. It is a potential alternative indicator for pelvic floor injury on the widely popular 2D transanal ultrasound.

Citations

Citations to this article as recorded by  
  • Enhancing Nonpharmacological Analgesia Pathways: Considerations for Post-Hemorrhoidectomy Care
    Hui Zhang, Hong Lu
    Diseases of the Colon & Rectum.2025; 68(11): e1894.     CrossRef
Benign proctology
Three-Dimensional Pelvic Floor Ultrasound Assessment of Pelvic Organ Prolapse: Minimal Levator Hiatus and Levator Ani Deficiency Score
Yongwoo Yune, Hong Yoon Jeong, Duk Hoon Park, Jong Kyun Lee
Ann Coloproctol. 2021;37(5):291-297.   Published online August 9, 2021
DOI: https://doi.org/10.3393/ac.2020.01095.0156
  • 6,967 View
  • 96 Download
  • 7 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
The purpose of this study was to determine whether levator ani deficiency (LAD) scores and minimal levator hiatus (MLH) areas affect Pelvic Organ Prolapse Quantification (POP-Q) stage.
Methods
This study was a retrospective chart review of patients with pelvic organ prolapse (POP) at Seoul Songdo Hospital between August 2019 and August 2020. Three-dimensional (3D) pelvic floor ultrasound, preoperative anal manometry, and other physiological tests were performed in 78 patients with POP symptoms. We divided the patients into mild prolapse and severe prolapse groups based on the POP-Q. We examined the LAD and MLH areas. LAD scores were categorized as mild, moderate, or severe.
Results
There were 32 patients (41.0%) in the mild prolapse group (POP-Q stage I and II) and 46 (59.0%) in the severe prolapse group (POP-Q stage III and IV). The mean LAD score was significantly higher in severe prolapse group (13.33±2.49 vs. 8.19±2.92, P<0.001), and the rate of severe deficiency was also significantly higher in the severe prolapse group (29 [63.0%] vs. 2 [6.3%], P<0.001). The mean MLH was also significantly larger in the severe prolapse group (17.91±2.74 cm2 vs. 14.95±2.60 cm2, P<0.001). In addition, both MLH and LAD scores tended to increase at each stage.
Conclusion
There is a strong positive correlation between the POP-Q stage and the MLH and LAD scores that can be seen on 3D pelvic floor ultrasound. The findings of this study, by objectively demonstrating LAD and MLH in women with POP, are an important contribution to POP.

Citations

Citations to this article as recorded by  
  • Pelvic floor dysfunction in patients with gestational diabetes mellitus
    Mustafa Arslan, Ramazan Kozan
    World Journal of Diabetes.2025;[Epub]     CrossRef
  • The predicting value of the ratio of levator hiatus diameter to fetal head circumference in pregnant women at 37 weeks of gestation in the progression of the second stage of labor and levator ani injury 6 weeks postpartum
    Bei Gan, Shan Zheng, Xiuyan Wu, Xuemei Li
    Heliyon.2024; 10(4): e25636.     CrossRef
  • Advancements in artificial intelligence for pelvic floor ultrasound analysis
    Xinghua Huang
    American Journal of Translational Research.2024; 16(4): 1037.     CrossRef
  • Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study
    Emilia Rotstein, Vilhelmina Ullemar, Marianne Starck, Gunilla Tegerstedt
    Acta Obstetricia et Gynecologica Scandinavica.2023; 102(9): 1236.     CrossRef
  • Correlation between clinical examination and perineal ultrasound in women treated for pelvic organ prolapse
    Célia Maheut, Thibaud Vernet, Hugo Le Boité, Hervé Fernandez, Perrine Capmas
    Journal of Gynecology Obstetrics and Human Reproduction.2023; 52(9): 102650.     CrossRef
  • Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
    Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
    International Journal of Surgery Case Reports.2022; 98: 107524.     CrossRef
  • Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
    Chungyeop Lee, Jong Lyul Lee
    The Ewha Medical Journal.2022;[Epub]     CrossRef
Case Report
Benign bowel disease
Successful detection and removal of predictable juvenile polyp: a case report
Kwang Yeon Kim, Jin Su Kim
Ann Coloproctol. 2023;39(5):435-438.   Published online July 21, 2021
DOI: https://doi.org/10.3393/ac.2021.00311.0044
  • 7,504 View
  • 137 Download
  • 2 Web of Science
  • 1 Citations
AbstractAbstract PDF
Juvenile polyp makes up 70% to 80% of pediatric colon polyp, and the average age of diagnosis is 2 to 5 years. The treatment of juvenile polyp in children is polypectomy through colonoscopy. The fact that the lumen of intestine is much smaller than that of adults and the need to perform polypectomy is a heavy burden on the endoscopists. Recently, fecal calprotectin (FC) has been found to be related to juvenile polyp. A previously healthy 34-month-old female patient presented to the pediatric gastroenterology department with intermittent bloody stools that were progressively worsening. FC level was abnormally elevated at 2,719 µg/g (normal, < 50 µg/g). The polyp was successfully removed with a endoscopic polypectomy. This is the first case in Korea to show that FC can be used to screen juvenile polyp in children. Caution must be taken that FC levels can increase with inflammation, regardless of the number or size of the polyps.

Citations

Citations to this article as recorded by  
  • Why is it worth looking for colorectal polyps in children using ultrasound? A case report and literature review
    Katarzyna Kamila Bąk-Drabik, Monika Prokurat, Agnieszka Szymlak, Anna Jarzumbek, Paweł Ziora, Jarosław Kwiecień
    Pediatria i Medycyna Rodzinna.2025; 20(4): 418.     CrossRef
Original Articles
Benign proctology
Comparison of 3-Dimensional Pelvic Floor Ultrasonography and Defecography for Assessment of Posterior Pelvic Floor Disorders
Hong Yoon Jeong, Shi-Jun Yang, Dong Ho Cho, Duk Hoon Park, Jong Kyun Lee
Ann Coloproctol. 2020;36(4):256-263.   Published online March 16, 2020
DOI: https://doi.org/10.3393/ac.2020.02.09
  • 5,472 View
  • 128 Download
  • 6 Web of Science
  • 7 Citations
AbstractAbstract PDF
Purpose
The aim of this study was to determine the accuracy of 3-dimensional (3D) pelvic floor ultrasonography and compare it with defecography in assessment of posterior pelvic disorders.
Methods
Eligible patients were consecutive women undergoing 3D pelvic floor ultrasonography at one hospital between August 2017 and February 2019. All 3D pelvic floor ultrasonography was performed by one examiner. A total of 167 patients with suspected posterior pelvic disorder was retrospectively enrolled in the study. The patients were divided into 3 groups according to the main symptoms.
Results
There were 82 rectoceles on defecography (55 barium trapping) and 84 on 3D pelvic floor ultrasonography. Each modality identified 6 enteroceles. There were 43 patients with pelvic floor dyssynergia on defecography and 41 on ultrasonography. There were 84 patients with intussusception on defecography and 41 on 3D pelvic floor ultrasonography. Agreement of the 2 diagnostic tests was confirmed using Cohen’s kappa value. Rectocele (kappa, 0.784) and enterocele (kappa, 0.654) both indicated good agreement between defecography and 3D pelvic floor ultrasonography. In addition, pelvic floor dyssynergia (kappa, 0.406) showed moderate agreement, while internal intussusception (kappa, 0.296) had fair agreement.
Conclusion
This study showed good agreement for detection of posterior pelvic disorders between defecography and 3D pelvic floor ultrasonography.

Citations

Citations to this article as recorded by  
  • Can we use integrated total pelvic floor ultrasound as a screening tool in defaecatory pelvic floor dysfunction? A prospective evaluation of the accuracy of integrated total pelvic floor ultrasound compared with defaecation proctography
    Charlotte Ralston, Max Reena, Deepa Solanki, Samantha Morris, Alexis M. P. Schizas, Andrew B. Williams, Alison J. Hainsworth
    Colorectal Disease.2025;[Epub]     CrossRef
  • Clinical value of transperineal ultrasound in evaluating the diagnostic grade of rectocele in Chinese women with obstructed defecation syndrome: An observational study
    Yunlin Jiang, Zhimin Fan, Ling Gao, Guangshu Shen, Jingjing Yue, Xiaofeng Wang, Xueping Zheng, Yahong Xue
    Medicine.2024; 103(36): e39259.     CrossRef
  • Rectal prolapse and surgery for faecal incontinence
    Judith Johnston, Athur Harikrishnan
    Surgery (Oxford).2023; 41(7): 449.     CrossRef
  • Role of contrast-enhanced ultrasonography in MR-guided focused ultrasound ablation on uterus fibroids: lesion selection and assessment of ablative effects
    Wen Luo, Pei-di Zhang, Xiao Yang, Jian-min Zheng, Ying Liu, Xing Tang, Hai-jing Liu, Lei Ding, Li-na Pang, Xiao-dong Zhou, Li-wen Liu, Min-wen Zheng
    European Radiology.2022; 32(3): 2110.     CrossRef
  • Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
    Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
    International Journal of Surgery Case Reports.2022; 98: 107524.     CrossRef
  • Is It a Refractory Disease?- Fecal Incontinence; beyond Medication
    Chungyeop Lee, Jong Lyul Lee
    The Ewha Medical Journal.2022;[Epub]     CrossRef
  • Three-Dimensional Pelvic Floor Ultrasound Assessment of Pelvic Organ Prolapse: Minimal Levator Hiatus and Levator Ani Deficiency Score
    Yongwoo Yune, Hong Yoon Jeong, Duk Hoon Park, Jong Kyun Lee
    Annals of Coloproctology.2021; 37(5): 291.     CrossRef
Accuracy of Preoperative Staging of Rectal Cancer: Comparative Study of Transrectal Ultrasonography and Computerized Tomography.
Cheon, Seung Hui , Lee, Suk Hwan , Kim, Kwang Ho , Park, Eung Bum
J Korean Soc Coloproctol. 2003;19(5):327-333.
  • 1,361 View
  • 3 Download
AbstractAbstract PDF
PURPOSE
Preoperative assessment of the depth of invasion in the rectal wall and of lymph node metastases is very important in determining the treatment modality in rectal cancer. The purposes of study were to evaluate the accuracy of transrectal ultrasonography (TRUS) in preoperative staging of rectal cancer and to compare that accuracy with the accuracy for computed tomography (CT).
METHODS
We reviewed 59 patients who were diagnosed as having rectal cancer and who had been staged by using TRUS and CT preoperatively. Ultrasonographic tumor (uT) and nodal (uN) stage and computerized tomographic tumor (cT) and nodal (cN) stage were entered into the database prospectively. The accuracy of each staging was compared with the pathologic staging. The accuracy, the sensitivity, the specificity, the positive predictive value, and the negative predictive value of each diagnostic test were calculated. Chi- square tests were conducted to identify the factors influencing the accuracy.
RESULTS
The accuracies of TRUS and CT in assessing the depth of invasion were 66.1% and 62.5%, respectively. The accuracies of TRUS and CT in assessing the nodal involvement in patients treated with radical surgery were 70.4% and 63.6%, respectively. For detection of fat infiltration, the sensitivities were 97.4% for TRUS and 76.3% for CT. The specificities were 45.0% for TRUS and 55.6% for CT. The sensitivities for detection of lymph node involvement were 59.3% for TRUS and 42.9% for CT. The specificities were 81.5% for TRUS and 85.2% for CT. The gross appearance of the tumor had a significant influence on the assessment of the depth of invasion (P=0.015). In 9 out of 77 patients (11.7%) could not be performed the TRUS examination due to obstruction or the location of the tumor.
CONCLUSIONS
In spite of some limitations, TRUS is considered a very useful tool in the preoperative assessment of the depth of invasion and of the lymph node involvement in rectal cancer. However, CT examination is mandatory to overcome the limitations of TRUS in the preoperative diagnosis of rectal cancers.
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