Patient history
- Age / sex: 29 y/o Female
- Relevant symptoms: Urgency. Incontinence
- Pertinent medical history: Prior grade 3 OASI
- Clinical question / referral reason: Sphincter integrity
Imaging modality
- Modality: Endoanal Ultrasound
- Key sequences/views: Mid-canal 360-degree static Ultrasound image
- Positioning / technique: Patient in left lateral with 12 o'clock anteriorly
Interpretation
- Key findings: Intact IAS with anterior tethering at 1 o'clock suggesting evidence of prior repair. Mild EAS fibrosis at this location.
- Impression: Repaired OASI. IAS tethering and likley reactive change.
- Clinical relevance / teaching point: Always assess the contour of the IAS.
- Pitfalls / things that could be missed: This case is challenging as the clinical context alters the interpretation. It also explains the patients symptoms of incontinence due to reduced resting tone due to reactive damage to the IAS.
