Van Outryve M J, Pelckmans P A, Michielsen P P, Van Maercke Y M
Division of Gastroenterology, University Hospital of Antwerp, Edegem, Belgium.
Gastroenterology. 1991 Nov;101(5):1171-7. doi: 10.1016/0016-5085(91)90064-r.
Anorectal lesions are common and can develop silently in patients with Crohn's disease. Transrectal ultrasound examinations were performed to study 40 healthy individuals and 40 patients with Crohn's disease. A rigid linear endorectal probe was used to examine the rectal wall, the perirectal tissues, and the anal sphincter. In healthy individuals, the rectal wall showed five layers with a total diameter of maximum 4 mm. The anal sphincter was clearly visualized as an echo-poor and sharply delineated structure. No pathological lesions were detected perirectally. In Crohn's disease, an enlargement of the rectal wall was seen in 16 patients and heterogeneity of the anal sphincter in 19 patients. This technique detected lesions missed with the routine proctological examinations: four pararectal abscesses, two pararectal fistulas, two para-anal abscesses, and one para-anal fistula. In all examined subjects, the anal sphincter increased in breadth during squeezing and in length during straining. It is concluded that transrectal ultrasonography sharply delineates the rectal wall and the anal sphincter at rest and under dynamic conditions and detects unknown abscesses and fistulas in the pararectal and para-anal tissues in patients with Crohn's disease.
肛门直肠病变很常见，可在克罗恩病患者中悄然发生。对40名健康个体和40名克罗恩病患者进行了经直肠超声检查。使用刚性线性直肠内探头检查直肠壁、直肠周围组织和肛门括约肌。在健康个体中，直肠壁显示出五层结构，总直径最大为4毫米。肛门括约肌清晰可见，呈低回声且边界清晰的结构。直肠周围未检测到病理性病变。在克罗恩病患者中，16例患者可见直肠壁增厚，19例患者可见肛门括约肌不均匀。该技术检测到了常规直肠检查遗漏的病变：4例直肠旁脓肿、2例直肠旁瘘、2例肛门旁脓肿和1例肛门旁瘘。在所有受检对象中，肛门括约肌在收缩时宽度增加，在用力排便时长度增加。结论是，经直肠超声检查能清晰显示静息和动态状态下的直肠壁和肛门括约肌，并能检测出克罗恩病患者直肠旁和肛门旁组织中未知的脓肿和瘘管。
