The problem is the contrast agent we use now where we are is a isosmotic contrast. As a result of that, we changed. And we use a contrast agent that's very dense, but it's isosmotic to body fluids. So if it were to get into the perineum, there would not be any fluid shifts.
The problem is the contrast agent we use now where we are is a isosmotic contrast. As a result of that, we changed. And we use a contrast agent that's very dense, but it's isosmotic to body fluids. So if it were to get into the perineum, there would not be any fluid shifts.
The problem is the contrast agent we use now where we are is a isosmotic contrast. As a result of that, we changed. And we use a contrast agent that's very dense, but it's isosmotic to body fluids. So if it were to get into the perineum, there would not be any fluid shifts.
The problem is the contrast agent we use now where we are is a isosmotic contrast. As a result of that, we changed. And we use a contrast agent that's very dense, but it's isosmotic to body fluids. So if it were to get into the perineum, there would not be any fluid shifts.
The lateral view is the best view for measuring your sacral index. There is less alteration. On the AP view, it always tends to be a little bit smaller than it does on the lateral view.
The lateral view is the best view for measuring your sacral index. There is less alteration. On the AP view, it always tends to be a little bit smaller than it does on the lateral view.
clinicalIn females, prenatal ultrasound showing bilateral hydronephrosis, small bladder, and dilated vagina suggests cloaca.↗
▶Ep 23 · 4:40
quoteThe combination of those three components in a female should make you begin to at least consider the diagnosis of cloacal malformation.↗
▶Ep 23 · 7:14
clinicalCalcified enteroliths in the GI tract on neonatal KUB indicate urine mixing with meconium, suggesting a recto-GU fistula at least at the bulbar level or higher.↗
▶Ep 23 · 8:00
quoteSo you know that there is urine mixing with meconium, and that tends to calcify fairly quickly. So this patient has a rectal GU connection.↗
▶Ep 23 · 10:08
clinicalAfter 20 to 24 weeks gestation, T1 hyperintensity of meconium within the colon should be visible on fetal MRI; loss of T1 hyperintensity and bright T2 signal suggests urine mixing.↗
▶Ep 23 · 10:08
clinicalOn fetal MRI, the distal rectum should extend at least 10 mm below the bladder neck in the second trimester, up to 20–24 mm in the third trimester; high position suggests ARM.↗
▶Ep 23 · 14:10
quoteWhen you see a hemisacrum, you have to start thinking about curavenous triad. And you have to presume that there is a presacral mass there.↗
▶Ep 23 · 15:35
clinicalWhen hemisacrum is seen in a patient with anal malformation, Currarino triad must be assumed and presacral mass must be looked for.↗
▶Ep 23 · 17:00
clinicalFor sacral ratio measurement, a true AP pelvis (not angled sacral view) and lateral pelvis are required; the lateral view is more accurate.↗
▶Ep 23 · 17:00
quoteThe lateral view is the best view for measuring your sacral index. There is less alteration. On the AP view, it always tends to be a little bit smaller than it does on the lateral view.↗
▶Ep 23 · 21:48
clinicalNormal sacral ratio ranges from 0.6 to 1.0; below 0.3 predicts very low likelihood of continence.↗
▶Ep 23 · 23:00
quoteIf you're particularly under 0.3, the likelihood of continence is very low.↗
▶Ep 23 · 36:40
clinicalCross-table lateral (invertogram) must be performed after 24 to 36 hours to allow enough air and pressure to show the true level of the distal rectal pouch.↗
▶Ep 23 · 38:00
quoteYou really can't do this and get an accurate knowledge or an accurate representation of where that distal rectum really is unless you do this after 24 to 36 hours.↗
▶Ep 23 · 55:00
clinicalIt is difficult to distinguish radiologically between prostatic and bulbar urethral fistulae; the bend in the urethra is used as an approximate landmark.↗
▶Ep 23 · 56:20
quoteThe key is making sure that you have very good pressure and you have a good length of colon there for the surgeons.↗
▶Ep 23 · 56:56
clinicalDistal colonic segments that are very dilated and atonic are at higher risk of perforation during colostography due to Laplace's law (thin wall, high pressure).↗
▶Ep 23 · 58:21
clinicalPerforation during colostography with hyperosmotic contrast (e.g., cystoconray, ~400 mOsm) causes immediate fluid shift and peritonitis requiring emergent IV fluids and surgical consultation.↗
▶Ep 23 · 59:58
clinicalIso-osmotic contrast is now preferred for distal colostography to avoid fluid shifts if perforation occurs.↗
▶Ep 23 · 1:00:20
quoteThe problem is the contrast agent we use now where we are is a isosmotic contrast. As a result of that, we changed. And we use a contrast agent that's very dense, but it's isosmotic to body fluids. So if it were to get into the perineum, there would not be any fluid shifts.↗
ARMs in Male Patients: Pediatric Colorectal Controversies 2014
▶Ep 29 · 28:31
clinicalCombining distal colostography with VCUG in the same setting provides complete anatomical information; the colostogram is done first, contrast removed, then VCUG performed↗
▶Ep 29 · 28:50
clinicalDistal colostography requires both lateral and oblique/AP views with full distention and exact measurements to adequately assess fistula location and rectal length↗
▶Ep 29 · 36:37
clinicalBladder-neck fistulas are distinguished from prostatic fistulas by location above the angle of the urethra; prostatic fistulas are at or below the urethral angle↗
▶Ep 29 · 38:00
clinicalCystoscopy by an experienced urologist can identify the fistula in approximately 9 out of 10 cases, though prior surgical experience found only 3 out of 10 fistulas visible cystoscopically↗
clinicalIn females, prenatal ultrasound showing bilateral hydronephrosis, small bladder, and dilated vagina suggests cloaca.↗
▶Ep 7 · 4:40
quoteThe combination of those three components in a female should make you begin to at least consider the diagnosis of cloacal malformation.↗
▶Ep 7 · 7:14
clinicalCalcified enteroliths in the GI tract on neonatal KUB indicate urine mixing with meconium, suggesting a recto-GU fistula at least at the bulbar level or higher.↗
▶Ep 7 · 8:00
quoteSo you know that there is urine mixing with meconium, and that tends to calcify fairly quickly. So this patient has a rectal GU connection.↗
▶Ep 7 · 10:08
clinicalOn fetal MRI, the distal rectum should extend at least 10 mm below the bladder neck in the second trimester, up to 20–24 mm in the third trimester; high position suggests ARM.↗
▶Ep 7 · 10:08
clinicalAfter 20 to 24 weeks gestation, T1 hyperintensity of meconium within the colon should be visible on fetal MRI; loss of T1 hyperintensity and bright T2 signal suggests urine mixing.↗
▶Ep 7 · 14:10
quoteWhen you see a hemisacrum, you have to start thinking about curavenous triad. And you have to presume that there is a presacral mass there.↗
▶Ep 7 · 15:35
clinicalWhen hemisacrum is seen in a patient with anal malformation, Currarino triad must be assumed and presacral mass must be looked for.↗
▶Ep 7 · 17:00
quoteThe lateral view is the best view for measuring your sacral index. There is less alteration. On the AP view, it always tends to be a little bit smaller than it does on the lateral view.↗
▶Ep 7 · 17:00
clinicalFor sacral ratio measurement, a true AP pelvis (not angled sacral view) and lateral pelvis are required; the lateral view is more accurate.↗
▶Ep 7 · 21:48
clinicalNormal sacral ratio ranges from 0.6 to 1.0; below 0.3 predicts very low likelihood of continence.↗
▶Ep 7 · 23:00
quoteIf you're particularly under 0.3, the likelihood of continence is very low.↗
▶Ep 7 · 36:40
clinicalCross-table lateral (invertogram) must be performed after 24 to 36 hours to allow enough air and pressure to show the true level of the distal rectal pouch.↗
▶Ep 7 · 38:00
quoteYou really can't do this and get an accurate knowledge or an accurate representation of where that distal rectum really is unless you do this after 24 to 36 hours.↗
▶Ep 7 · 55:00
clinicalIt is difficult to distinguish radiologically between prostatic and bulbar urethral fistulae; the bend in the urethra is used as an approximate landmark.↗
▶Ep 7 · 56:20
quoteThe key is making sure that you have very good pressure and you have a good length of colon there for the surgeons.↗
▶Ep 7 · 56:56
clinicalDistal colonic segments that are very dilated and atonic are at higher risk of perforation during colostography due to Laplace's law (thin wall, high pressure).↗
▶Ep 7 · 58:21
clinicalPerforation during colostography with hyperosmotic contrast (e.g., cystoconray, ~400 mOsm) causes immediate fluid shift and peritonitis requiring emergent IV fluids and surgical consultation.↗
▶Ep 7 · 59:58
clinicalIso-osmotic contrast is now preferred for distal colostography to avoid fluid shifts if perforation occurs.↗
▶Ep 7 · 1:00:20
quoteThe problem is the contrast agent we use now where we are is a isosmotic contrast. As a result of that, we changed. And we use a contrast agent that's very dense, but it's isosmotic to body fluids. So if it were to get into the perineum, there would not be any fluid shifts.↗
clinicalIn females, prenatal ultrasound showing bilateral hydronephrosis, small bladder, and dilated vagina suggests cloaca.↗
▶Ep 59 · 2:12
clinicalIn females, prenatal ultrasound showing bilateral hydronephrosis, small bladder, and dilated vagina suggests cloaca.↗
▶Ep 59 · 4:40
quoteThe combination of those three components in a female should make you begin to at least consider the diagnosis of cloacal malformation.↗
▶Ep 59 · 4:40
quoteThe combination of those three components in a female should make you begin to at least consider the diagnosis of cloacal malformation.↗
▶Ep 59 · 7:14
clinicalCalcified enteroliths in the GI tract on neonatal KUB indicate urine mixing with meconium, suggesting a recto-GU fistula at least at the bulbar level or higher.↗
▶Ep 59 · 7:14
clinicalCalcified enteroliths in the GI tract on neonatal KUB indicate urine mixing with meconium, suggesting a recto-GU fistula at least at the bulbar level or higher.↗
▶Ep 59 · 8:00
quoteSo you know that there is urine mixing with meconium, and that tends to calcify fairly quickly. So this patient has a rectal GU connection.↗
▶Ep 59 · 8:00
quoteSo you know that there is urine mixing with meconium, and that tends to calcify fairly quickly. So this patient has a rectal GU connection.↗
▶Ep 59 · 10:08
clinicalOn fetal MRI, the distal rectum should extend at least 10 mm below the bladder neck in the second trimester, up to 20–24 mm in the third trimester; high position suggests ARM.↗
▶Ep 59 · 10:08
clinicalAfter 20 to 24 weeks gestation, T1 hyperintensity of meconium within the colon should be visible on fetal MRI; loss of T1 hyperintensity and bright T2 signal suggests urine mixing.↗
▶Ep 59 · 10:08
clinicalOn fetal MRI, the distal rectum should extend at least 10 mm below the bladder neck in the second trimester, up to 20–24 mm in the third trimester; high position suggests ARM.↗
▶Ep 59 · 10:08
clinicalAfter 20 to 24 weeks gestation, T1 hyperintensity of meconium within the colon should be visible on fetal MRI; loss of T1 hyperintensity and bright T2 signal suggests urine mixing.↗
▶Ep 59 · 14:10
quoteWhen you see a hemisacrum, you have to start thinking about curavenous triad. And you have to presume that there is a presacral mass there.↗
▶Ep 59 · 14:10
quoteWhen you see a hemisacrum, you have to start thinking about curavenous triad. And you have to presume that there is a presacral mass there.↗
▶Ep 59 · 15:35
clinicalWhen hemisacrum is seen in a patient with anal malformation, Currarino triad must be assumed and presacral mass must be looked for.↗
▶Ep 59 · 15:35
clinicalWhen hemisacrum is seen in a patient with anal malformation, Currarino triad must be assumed and presacral mass must be looked for.↗
▶Ep 59 · 17:00
clinicalFor sacral ratio measurement, a true AP pelvis (not angled sacral view) and lateral pelvis are required; the lateral view is more accurate.↗
▶Ep 59 · 17:00
quoteThe lateral view is the best view for measuring your sacral index. There is less alteration. On the AP view, it always tends to be a little bit smaller than it does on the lateral view.↗
▶Ep 59 · 17:00
clinicalFor sacral ratio measurement, a true AP pelvis (not angled sacral view) and lateral pelvis are required; the lateral view is more accurate.↗
▶Ep 59 · 17:00
quoteThe lateral view is the best view for measuring your sacral index. There is less alteration. On the AP view, it always tends to be a little bit smaller than it does on the lateral view.↗
▶Ep 59 · 21:48
clinicalNormal sacral ratio ranges from 0.6 to 1.0; below 0.3 predicts very low likelihood of continence.↗
▶Ep 59 · 21:48
clinicalNormal sacral ratio ranges from 0.6 to 1.0; below 0.3 predicts very low likelihood of continence.↗
▶Ep 59 · 23:00
quoteIf you're particularly under 0.3, the likelihood of continence is very low.↗
▶Ep 59 · 23:00
quoteIf you're particularly under 0.3, the likelihood of continence is very low.↗
▶Ep 59 · 36:40
clinicalCross-table lateral (invertogram) must be performed after 24 to 36 hours to allow enough air and pressure to show the true level of the distal rectal pouch.↗
▶Ep 59 · 36:40
clinicalCross-table lateral (invertogram) must be performed after 24 to 36 hours to allow enough air and pressure to show the true level of the distal rectal pouch.↗
▶Ep 59 · 38:00
quoteYou really can't do this and get an accurate knowledge or an accurate representation of where that distal rectum really is unless you do this after 24 to 36 hours.↗
▶Ep 59 · 38:00
quoteYou really can't do this and get an accurate knowledge or an accurate representation of where that distal rectum really is unless you do this after 24 to 36 hours.↗
▶Ep 59 · 55:00
clinicalIt is difficult to distinguish radiologically between prostatic and bulbar urethral fistulae; the bend in the urethra is used as an approximate landmark.↗
▶Ep 59 · 55:00
clinicalIt is difficult to distinguish radiologically between prostatic and bulbar urethral fistulae; the bend in the urethra is used as an approximate landmark.↗
▶Ep 59 · 56:20
quoteThe key is making sure that you have very good pressure and you have a good length of colon there for the surgeons.↗
▶Ep 59 · 56:20
quoteThe key is making sure that you have very good pressure and you have a good length of colon there for the surgeons.↗
▶Ep 59 · 56:56
clinicalDistal colonic segments that are very dilated and atonic are at higher risk of perforation during colostography due to Laplace's law (thin wall, high pressure).↗
▶Ep 59 · 56:56
clinicalDistal colonic segments that are very dilated and atonic are at higher risk of perforation during colostography due to Laplace's law (thin wall, high pressure).↗
▶Ep 59 · 58:21
clinicalPerforation during colostography with hyperosmotic contrast (e.g., cystoconray, ~400 mOsm) causes immediate fluid shift and peritonitis requiring emergent IV fluids and surgical consultation.↗
▶Ep 59 · 58:21
clinicalPerforation during colostography with hyperosmotic contrast (e.g., cystoconray, ~400 mOsm) causes immediate fluid shift and peritonitis requiring emergent IV fluids and surgical consultation.↗
▶Ep 59 · 59:58
clinicalIso-osmotic contrast is now preferred for distal colostography to avoid fluid shifts if perforation occurs.↗
▶Ep 59 · 59:58
clinicalIso-osmotic contrast is now preferred for distal colostography to avoid fluid shifts if perforation occurs.↗
▶Ep 59 · 1:00:20
quoteThe problem is the contrast agent we use now where we are is a isosmotic contrast. As a result of that, we changed. And we use a contrast agent that's very dense, but it's isosmotic to body fluids. So if it were to get into the perineum, there would not be any fluid shifts.↗
▶Ep 59 · 1:00:20
quoteThe problem is the contrast agent we use now where we are is a isosmotic contrast. As a result of that, we changed. And we use a contrast agent that's very dense, but it's isosmotic to body fluids. So if it were to get into the perineum, there would not be any fluid shifts.↗
ARMs in Male Patients: Pediatric Colorectal Controversies 2014
▶Ep 66 · 28:31
clinicalCombining distal colostography with VCUG in the same setting provides complete anatomical information; the colostogram is done first, contrast removed, then VCUG performed↗
▶Ep 66 · 28:31
clinicalCombining distal colostography with VCUG in the same setting provides complete anatomical information; the colostogram is done first, contrast removed, then VCUG performed↗
▶Ep 66 · 28:50
clinicalDistal colostography requires both lateral and oblique/AP views with full distention and exact measurements to adequately assess fistula location and rectal length↗
▶Ep 66 · 28:50
clinicalDistal colostography requires both lateral and oblique/AP views with full distention and exact measurements to adequately assess fistula location and rectal length↗
▶Ep 66 · 36:37
clinicalBladder-neck fistulas are distinguished from prostatic fistulas by location above the angle of the urethra; prostatic fistulas are at or below the urethral angle↗
▶Ep 66 · 36:37
clinicalBladder-neck fistulas are distinguished from prostatic fistulas by location above the angle of the urethra; prostatic fistulas are at or below the urethral angle↗
▶Ep 66 · 38:00
clinicalCystoscopy by an experienced urologist can identify the fistula in approximately 9 out of 10 cases, though prior surgical experience found only 3 out of 10 fistulas visible cystoscopically↗
▶Ep 66 · 38:00
clinicalCystoscopy by an experienced urologist can identify the fistula in approximately 9 out of 10 cases, though prior surgical experience found only 3 out of 10 fistulas visible cystoscopically↗
ARMs in Male Patients: Pediatric Colorectal Controversies 2014
▶Ep 27 · 28:31
clinicalCombining distal colostography with VCUG in the same setting provides complete anatomical information; the colostogram is done first, contrast removed, then VCUG performed↗
▶Ep 27 · 28:50
clinicalDistal colostography requires both lateral and oblique/AP views with full distention and exact measurements to adequately assess fistula location and rectal length↗
▶Ep 27 · 36:37
clinicalBladder-neck fistulas are distinguished from prostatic fistulas by location above the angle of the urethra; prostatic fistulas are at or below the urethral angle↗
▶Ep 27 · 38:00
clinicalCystoscopy by an experienced urologist can identify the fistula in approximately 9 out of 10 cases, though prior surgical experience found only 3 out of 10 fistulas visible cystoscopically↗
ARMs in Male Patients: Pediatric Colorectal Controversies 2014
▶Ep 4 · 28:31
clinicalCombining distal colostography with VCUG in the same setting provides complete anatomical information; the colostogram is done first, contrast removed, then VCUG performed↗
▶Ep 4 · 28:31
clinicalCombining distal colostography with VCUG in the same setting provides complete anatomical information; the colostogram is done first, contrast removed, then VCUG performed↗
▶Ep 4 · 28:50
clinicalDistal colostography requires both lateral and oblique/AP views with full distention and exact measurements to adequately assess fistula location and rectal length↗
▶Ep 4 · 28:50
clinicalDistal colostography requires both lateral and oblique/AP views with full distention and exact measurements to adequately assess fistula location and rectal length↗
▶Ep 4 · 36:37
clinicalBladder-neck fistulas are distinguished from prostatic fistulas by location above the angle of the urethra; prostatic fistulas are at or below the urethral angle↗
▶Ep 4 · 36:37
clinicalBladder-neck fistulas are distinguished from prostatic fistulas by location above the angle of the urethra; prostatic fistulas are at or below the urethral angle↗
▶Ep 4 · 38:00
clinicalCystoscopy by an experienced urologist can identify the fistula in approximately 9 out of 10 cases, though prior surgical experience found only 3 out of 10 fistulas visible cystoscopically↗
▶Ep 4 · 38:00
clinicalCystoscopy by an experienced urologist can identify the fistula in approximately 9 out of 10 cases, though prior surgical experience found only 3 out of 10 fistulas visible cystoscopically↗
