Endorectal ultrasound (ERUS) in pelvic disorders

Abstract

Endorectal ultrasound (ERUS) imaging is a complex process using electronic devices to control ultrasound waves and produce images of anatomic structures. It is a simple, cheep and well-tolerated procedure that provides excellent images of rectal and anal canal wall and pelvic floor muscles together with surrounding organs and tissues. The direct imaging of anal canal and pelvic floor muscles with surrounding tissues allows one to identify sphincter defects, anorectal abscesses and fistulas as well as great variety of benign and malignant pathology of the pelvis. Basically, techniques for ERUS are very similar, but there are some slight modifications regarding equipment, indications, and localization of pathologic process. We describe the technique, indications, results and pitfalls of ERUS with the Bruel and Kjaer type 1850 endosonic probe with 7 and 10 MHz transducers in benign pelvic disorders.

Sonographic Evaluation of Obstetric Anal Injuries

“…46 The classic approach of EAUS is by using a 2D 7 to 10 MHz rotating endoprobe (focal range 5-45 mm), 12 to 17 mm in diameter, filled with degassed water, which allows a 360 o axial view of the anal canal. The patient lies in the left lateral or prone/lithotomy position, 47,48 although the latter is generally preferred for the acquisition of optimal images and also to avoid deformation of the anterior anatomic elements. 48 Digital anal examination prior to the sonographic examination is recommended, to obtain information on the anatomy of the anal canal and to exclude the presence of scars or stenotic lesions.…”

“…The patient lies in the left lateral or prone/lithotomy position, 47,48 although the latter is generally preferred for the acquisition of optimal images and also to avoid deformation of the anterior anatomic elements. 48 Digital anal examination prior to the sonographic examination is recommended, to obtain information on the anatomy of the anal canal and to exclude the presence of scars or stenotic lesions. 48 The endoscopic probe, covered with a lubricated condom is inserted about 6 cm into the rectum and as the probe is withdrawn down the anal canal, images of the pubo rectalis muscle, the anal mucosa and submucosa, IAS, longitudinal and EAS become visible.…”

“…48 Digital anal examination prior to the sonographic examination is recommended, to obtain information on the anatomy of the anal canal and to exclude the presence of scars or stenotic lesions. 48 The endoscopic probe, covered with a lubricated condom is inserted about 6 cm into the rectum and as the probe is withdrawn down the anal canal, images of the pubo rectalis muscle, the anal mucosa and submucosa, IAS, longitudinal and EAS become visible. Two-dimensional endoanal ultrasonography generates cross-sectional images in the axial plane only.…”

Point-of-care Transperineal Ultrasound to Diagnose Abscess in the Emergency Department

“…Magnetic resonance imaging (MRI) and endorectal ultrasonography are alternative imaging modalities with higher accuracy. However, their use in the emergency department (ED) is limited, partly because of high cost, inconvenience to patient and physician, significant time needed to complete the exam, and lack of availability in the ED 5–8…”