Constipation ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Endoanal ultrasound may be helpful for diagnosing underlying diseases causing constipation, particularly sphincter pathologies. Findings on an ultrasound suggestive of sphincter disorders are decline in thickness, depth, and size of the sphincter muscle. Endoanal ultrasound findings are scored through Starck scoring system, based on thickness, depth, and size of the sphincter muscles. The sphincter abnormality is classified as small (score of 1-4), moderate (score of 5-7), or large (score of 8-16).

Ultrasound

Endoanal ultrasonography

Endoanal ultrasound may be helpful for diagnosing underlying diseases causing constipation, particularly sphincter pathologies. Findings on an ultrasound suggestive of sphincter disorders include:

Starck scoring system

Defect Score
0 1 2 3
Length of defect None ≤1/2 >1/2 Whole
Depth of defect None Partial Total
Size of defect None ≤90° 91°-180° >180°
  • Starck scoring system is used for both internal and external anal sphincters and ranges from 0-16 points.
  • The sphincter abnormality is graded on the basis of points into following categories:[2]
    • Small: Score of 1-4
    • Moderate: Score of 5-7
    • Large: Score of 8-16

References

  1. Caldaro T, Romeo E, De Angelis P, Gambitta RA, Rea F, Torroni F, Foschia F, di Abriola GF, Dall'Oglio L (2012). "Three-dimensional endoanal ultrasound and anorectal manometry in children with anorectal malformations: new discoveries". J. Pediatr. Surg. 47 (5): 956–63. doi:10.1016/j.jpedsurg.2012.01.051. PMID 22595581.
  2. Starck, M.; Bohe, M.; Valentin, L. (2003). "Results of endosonographic imaging of the anal sphincter 2-7 days after primary repair of third- or fourth-degree obstetric sphincter tears". Ultrasound in Obstetrics and Gynecology. 22 (6): 609–615. doi:10.1002/uog.920. ISSN 0960-7692.