Kelvin F M, Maglinte D D, Hornback J A, Benson J T
Department of Radiology, Methodist Hospital of Indiana, Indiana University School of Medicine, Indianapolis 46206.
Radiology. 1992 Aug;184(2):547-51. doi: 10.1148/radiology.184.2.1620863.
The contribution of evacuation proctography (EP) to the evaluation of pelvic prolapse was assessed in 74 consecutive patients. A rectocele was demonstrated in 73 patients (99%); large rectoceles frequently showed barium trapping, but there was no correlation between these findings and rectal symptoms. An enterocele was detected at evacuation proctography in 13 patients (18%) (including two enteroceles seen only retrospectively), and a sigmoidocele was shown in four patients (5%). Physical examination resulted in detection of only seven enteroceles and of none of the sigmoidoceles. In 48 patients (65%), additional findings were evident at EP, including excessive pelvic floor descent, anal incontinence, rectal intussusception, and spastic pelvic floor. These data suggest that EP is particularly useful in the preoperative evaluation of pelvic prolapse if the patient has anorectal symptoms or is at risk for an enterocele. EP contributes to surgical planning by enabling identification of clinically unsuspected enteroceles and sigmoidoceles and coexistent disorders of rectal evacuation.
对74例连续患者评估了排粪造影（EP）对盆腔脏器脱垂评估的作用。73例患者（99%）显示直肠膨出；大的直肠膨出常显示钡剂潴留，但这些表现与直肠症状之间无相关性。在排粪造影时检测到13例患者（18%）有肠膨出（包括2例仅通过回顾性观察发现的肠膨出），4例患者（5%）显示乙状结肠膨出。体格检查仅发现7例肠膨出，未发现乙状结肠膨出。48例患者（65%）在排粪造影时有其他明显表现，包括盆底过度下降、肛门失禁、直肠套叠和盆底痉挛。这些数据表明，如果患者有肛门直肠症状或有肠膨出风险，排粪造影在盆腔脏器脱垂的术前评估中特别有用。排粪造影有助于手术规划，因为它能够识别临床上未怀疑的肠膨出和乙状结肠膨出以及并存的直肠排空障碍。
