Endoanal ultrasonography in establishing the diagnosis of fecal incontinence

The aim of this article is to review the possibilities of using endoanal ultrasound in the evaluation of fecal incontinence.

“Endoanal ultrasound (EAUS) greatly influences clinical decisions in the diagnosis and treatment of many anorectal diseases and disorders. It provides a means for accurate staging of anal and rectal cancers and dictates the need for or avoidance of surgical procedures. It plays also a major role in the evaluation of benign diseases such as various type of fistulas and submucosal masses.”

The authors discuss specific interpretation considerations when looking at EAUS images.  

“In many patients with incontinence, the anal sphincter muscle have localized defects. Any break in the continuity of hypoechoic ring of internal anal sphincter is abnormal and indicative of direct trauma (Fig.1). An interruption of the fibrillar echotexture of the external anal sphincter is abnormal (Fig.2). Discontinuity of the sphincter at EAUS indicates a tear. Scarring is characterized by loss of the normal texture that usually has low reflectiveness. The sphincter muscles may also show local thickening or thinning. Generalized external sphincter atrophy is difficult to appreciate because of the vaque contours of the muscle ring.”

A good article with detailed information on what to look for when evaluating results from EAUS exams.