{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T13:32:02Z","timestamp":1782567122089,"version":"3.54.5"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[1994,3,1]],"date-time":"1994-03-01T00:00:00Z","timestamp":762480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1994,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Defects of the external anal sphincter have traditionally been diagnosed by palpation, anal manometry and electromyography (EMG), but anal endosonography enables clear imaging of both the internal and external sphincter muscles. A study was performed to validate the interpretation of ultrasonographic images of external sphincter defects using histology as a \u2018gold standard\u2019. In addition the accuracy of clinical examination, manometry, EMG mapping and anal endosonography in the diagnosis of sphincter defects were compared prospectively. Twelve consecutive patients with faecal incontinence (11 women, one man; mean age 46 (range 30\u201364) years) who required sphincter repair underwent clinical assessment, anal manometry, concentric-needle EMG mapping and anal endosonography before surgery. The endosonographer was unaware of the history or results of physiological tests and the surgeon performing the repair was blind to the ultrasonographic findings. At operation most or all of the suspected defect was excised and examined histologically. The pathologist was unaware of the endosonographic or operative findings at the time of reporting. Combined operative and histological examination identified an external sphincter defect in nine of the 12 patients. Anal endosonography correctly identified all nine defects and the three normal sphincters. The accuracy of clinical examination was 50 per cent and that of both EMG and anal manometry 75 per cent. In addition, anal endosonography identified a defect of the internal anal sphincter in eight patients. External sphincter defects identified by endosonography have not been previously verified histologically. Precise sphincter assessment is mandatory for the correct management of faecal incontinence. Anal endosonography is more accurate than clinical and conventional physiological methods and also provides information on the internal sphincter.<\/jats:p>","DOI":"10.1002\/bjs.1800810349","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T20:04:37Z","timestamp":1172952277000},"page":"463-465","source":"Crossref","is-referenced-by-count":266,"title":["Anal endosonography for identifying external sphincter defects confirmed histologically"],"prefix":"10.1093","volume":"81","author":[{"given":"A H","family":"Sultan","sequence":"first","affiliation":[{"name":"Department of Radiology, St Mark's and St Bartholomew's Hospitals , London,","place":["UK"]},{"name":"Department of Physiology, St Mark's and St Bartholomew's Hospitals , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A","family":"Kamm","sequence":"additional","affiliation":[{"name":"Department of Physiology, St Mark's and St Bartholomew's Hospitals , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I C","family":"Talbot","sequence":"additional","affiliation":[{"name":"Department of Histopathology, St Mark's and St Bartholomew's Hospitals , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Department of Surgery, St Mark's and St Bartholomew's Hospitals , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C I","family":"Bartram","sequence":"additional","affiliation":[{"name":"Department of Radiology, St Mark's and St Bartholomew's Hospitals , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1994,3,1]]},"reference":[{"key":"2024092814272620100_bib1","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1002\/bjs.1800800435","article-title":"Anal endosonography and correlation with in vitro and in vivo anatomy","volume":"80","author":"Sultan","year":"1993","journal-title":"Br J Surg"},{"key":"2024092814272620100_bib2","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1007\/BF02156260","article-title":"A comparison between electromyography and anal endosonography in mapping external anal sphincter defects","volume":"33","author":"Law","year":"1990","journal-title":"Dis Colon Rectum"},{"key":"2024092814272620100_bib3","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1002\/bjs.1800790204","article-title":"Anal endosonographic findings in the follow-up of primarily sutured sphincteric ruptures","volume":"79","author":"Neilsen","year":"1992","journal-title":"Br J Surg"},{"key":"2024092814272620100_bib4","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/BF02053340","article-title":"Anal sphincter imaging in faecal incontinence using endosonography","volume":"35","author":"Cuesta","year":"1992","journal-title":"Dis Colon Rectum"},{"key":"2024092814272620100_bib5","first-page":"355","article-title":"Investigations of disorders of the anorectum and colon","volume":"67","author":"Henry","year":"1985","journal-title":"Ann R Coll Surg Engl"},{"key":"2024092814272620100_bib6","first-page":"216","volume-title":"Baill\u00e8re's Clinical Gastroenterology: Gastrointestinal Neurophysiology","author":"Lubowski","year":"1988"},{"key":"2024092814272620100_bib7","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/BF01889235","article-title":"Anal endosonography: technique and normal anatomy","volume":"14","author":"Law","year":"1989","journal-title":"Gastrointest Radiol"},{"key":"2024092814272620100_bib8","first-page":"S41","article-title":"Internal anal sphincter damage during sphincterotomy is underestimated. Prospective ultrasound study","volume":"34","author":"Sultan","year":"1993","journal-title":"Gut"},{"key":"2024092814272620100_bib9","first-page":"115","volume-title":"Atlas of Gastrointestinal Motility","author":"Sultan","year":"1993"},{"key":"2024092814272620100_bib10","doi-asserted-by":"crossref","first-page":"64","DOI":"10.3109\/17453678308992871","article-title":"Age dependent repair of muscle rupture","volume":"54","author":"Jarvinen","year":"1983","journal-title":"Acta Orthop Scand"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800810349","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/81\/3\/463\/59408387\/bjs1800810349.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/81\/3\/463\/59408387\/bjs1800810349.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T14:27:57Z","timestamp":1727533677000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/81\/3\/463\/6165406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,3,1]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1994,3,1]]},"published-print":{"date-parts":[[1994,3,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800810349","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1994,3]]},"published":{"date-parts":[[1994,3,1]]}}}