Takano M, Hamada A
Coloproctology Center, Takano Hospital, Kumamoto, Japan.
Dis Colon Rectum. 2000 Oct;43(10 Suppl):S6-11. doi: 10.1007/BF02237219.
For precise diagnosis and rational treatment of the increasing number of patients with descent of intrapelvic organ(s) and anatomic plane(s), dynamic contrast roentgenography of multiple intrapelvic organs and planes is described.
Sixty-six patients, consisting of 11 males, with a mean age (+/- standard deviation) of 65.6+/-14.2 years and with chief complaints of intrapelvic organ and perineal descent or defecation problems, were examined in this study. Dynamic contrast roentgenography was obtained by opacifying the ileum, urinary bladder, vagina, rectum, and the perineum. Films were taken at both squeeze and strain phases. On the films the lowest points of each organ and plane were plotted, and the distances from the standard line drawn at the upper surface of the sacrum were measured. The values were corrected to percentages according to the height of the sacrococcygeal bone of each patient. From these corrected values, organ or plane descents at strain and squeeze were diagnosed and graphically demonstrated as a descentgram in each patient.
Among 17 cases with subjective symptoms of bladder descent, 9 cases (52.9 percent) showed roentgenographic descent. By the same token, among the cases with subjective feeling of descent of the vagina, uterus, peritoneum, perineum, rectum, and anus, roentgenographic descent was confirmed in 15 of 20 (75 percent), 7 of 9 (77.8 percent), 6 of 16 (37.5 percent), 33 of 33 (100 percent), 25 of 37 (67.6 percent), and 22 of 36 (61.6 percent), respectively. The descentgrams were divided into three patterns: anorectal descent type, female genital descent type, and total organ descent type.
Dynamic contrast roentgenography and successive descentgraphy of multiple intrapelvic organs and planes are useful for objective diagnosis and rational treatment of patients with descent disorders of the intrapelvic organ(s) and plane(s).
为了对越来越多的盆腔内器官和解剖平面下移的患者进行精确诊断和合理治疗，本文描述了盆腔内多个器官和平面的动态对比X线检查。
本研究对66例患者进行了检查，其中男性11例，平均年龄（±标准差）为65.6±14.2岁，主要症状为盆腔内器官和会阴下移或排便问题。通过使回肠、膀胱、阴道、直肠和会阴显影来进行动态对比X线检查。在挤压和用力阶段均拍摄X线片。在X线片上标记每个器官和平面的最低点，并测量其与在骶骨上表面绘制的标准线的距离。根据每位患者骶尾骨的高度将这些值校正为百分比。根据这些校正后的值，诊断出用力和挤压时器官或平面的下移情况，并以每位患者的下移图的形式进行图形展示。
在17例有膀胱下移主观症状的病例中，9例（52.9%）显示出X线检查下移。同样，在有阴道、子宫、腹膜、会阴、直肠和肛门下移主观感觉的病例中，X线检查下移分别在20例中的15例（75%）、9例中的7例（77.8%）、16例中的6例（37.5%）、33例中的33例（100%）、37例中的25例（67.6%）和36例中的22例（61.6%）中得到证实。下移图分为三种类型：肛门直肠下移型、女性生殖器下移型和全器官下移型。
盆腔内多个器官和平面的动态对比X线检查及连续下移图对盆腔内器官和平面下移障碍患者的客观诊断和合理治疗是有用的。
