Point-of-care ultrasound assessment of transrectal diameter to evaluate fecal load in children with…

ObservationalPediatric surgery international· Jul 2026

Point-of-care ultrasound assessment of transrectal diameter to evaluate fecal load in children with anorectal malformations: adjunct imaging and utility in bowel management program.

Judith Lindert, Daniel Erkel, Naemi Kurzweil … Stefanie Märzheuser

Point-of-Care UltrasoundObservationalQ2IF 1.8

Rectal ultrasound diameter is significantly larger in symptomatic children with anorectal malformations

Point-of-care ultrasound assessment of transrectal diameter to evaluate fecal load in children with anorectal malformations: adjunct imaging and utility in bowel management program.

Judith Lindert … Stefanie Märzheuser

Pediatric surgery international · Jul 2026 · Q2 in General Medicine

Background

Children with anorectal malformations (anorectal malformations) frequently experience impaired bowel function and require long-term bowel management.

Purpose

This study aimed to evaluate point-of-care ultrasound (point-of-care ultrasound) measurement of transrectal diameter as an adjunct to clinical assessment for evaluating fecal load and monitoring bowel management in children with anorectal malformations.

Methods

In this prospective observational cohort study, children with anorectal malformations attending a tertiary colorectal clinic between April 2023 and January 2025 underwent standardized ultrasound assessment of transrectal diameter as part of a structured bowel management program.

n = 72 controls

Results

symptomatic children had a larger rectal diameter than asymptomatic peers or controls

63.3%

Sensitivity

96.3%

Specificity

More results

ROC analysis identified a transrectal diameter cut-off of 3.1 cm with a sensitivity of 63.3% and specificity of 96.3%.

During structured bowel management, transrectal diameter decreased below this threshold in parallel with clinical improvement.

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Conclusion · 1 of 2

Point-of-care ultrasound measurement of transrectal diameter is a feasible, radiation-free adjunct to clinical assessment in children with anorectal malformations.

Conclusion · 2 of 2

While it does not replace radiographic evaluation of global colonic stool burden, it may support monitoring within structured bowel management programs.