Fig. 1
From: Anatomical derangements after failed PSARP: correlating MRI and operative findings
Five-year-old boy presenting with faecal incontinence after PSARP. a Patient in the prone position, note the patulous anus. b Mid sagittal pelvic MRI (T2WI) demonstrating wide pelvic hiatus (H) with reference to Pubo-Coccygeal distance (PC); [calculated H/PC ratio = 0.7]. c Axial pelvic MRI (I-plane) demonstrating elongated transverse section of the anorectum (double arrow-head line). d Patient placed in the prone position at reoperation (Redo PSARP): reconstruction of the pelvic floor by re-approximation of the split halves of the diaphragmatic part of the levator ani behind the anorectum. Note: posterior tapering of anorectum. e, f Follow-up MRI (midsagittal and axial, respectively) performed 3 years later after reoperation demonstrating the effect of redo surgery on the internal pelvic MRI anatomy; note: short black arrows are pointing to the reconstructed levator plate behind anorectum; calculated [H/PC ratio = 0.58] (compare with b, c)