Freimanis M G, Wald A, Caruana B, Bauman D H
Department of Radiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612.
Invest Radiol. 1991 Jun;26(6):581-5. doi: 10.1097/00004424-199106000-00015.
Constipated patients evaluated by evacuation proctography may be subjected to vigorous medical therapy or surgery, even colectomy, based on radiographic findings that have been called "abnormal" in the literature. Criteria for normal defecography are not uniformly established, nor has correlation of structural or functional findings with symptoms been clearly documented. We prospectively studied 21 asymptomatic volunteers to assess the frequency of findings in a control population, and to establish a quantitative measure of normal rectal emptying. Standard defecography technique demonstrated rectocele, intussusception, pelvic descent, or puborectalis spasm in 14/21 volunteers (67%). The range of rectal emptying was 12.5% to 100%, with four subjects (19%) evacuating less than or equal to 40% of the barium paste. There was no correlation between severity of radiographic findings and degree of evacuation. Defecography results in patients being considered for symptomatic intervention should be interpreted cautiously, given the wide range of normal variation in a control population.
通过排粪造影评估的便秘患者可能会根据文献中被称为“异常”的影像学表现接受积极的药物治疗或手术，甚至结肠切除术。正常排便造影的标准尚未统一确立,结构或功能表现与症状之间的相关性也未得到明确记录。我们对21名无症状志愿者进行了前瞻性研究，以评估对照组中各种表现的出现频率，并建立正常直肠排空的定量指标。标准排粪造影技术显示，14/21名志愿者(67%)存在直肠膨出、肠套叠、盆腔脏器脱垂或耻骨直肠肌痉挛。直肠排空范围为12.5%至100%，4名受试者(19%)排出的钡糊小于或等于40%。影像学表现的严重程度与排空程度之间无相关性。鉴于对照组中正常变异范围很广，对于考虑进行症状性干预的患者，排便造影结果的解读应谨慎。
