Nelson J A, Daniels A U, Dodds W J
Invest Radiol. 1979 Jan-Feb;14(1):48-59. doi: 10.1097/00004424-197901000-00009.
Nine previously unreported rectal injuries caused by barium-enema examinations have been reviewed. In each case, the injury occurred in conjunction with inflation of a rectal balloon. Analysis of the clinical material suggested that certain mechanical properties of balloon catheter tips might transfer mechanical stress to the rectal wall and contribute to the observed injuries. Careful manometric evaluation of in vivo rectal balloons suggest that significant anatomic differences in patients may be clinically important. Further experimental bench studies revealed undesirable mechanical properties in many commercially available rectal balloon catheters. These mechanical problems include low compliance, asymmetrical inflation, strong lateral and anterior displacement of a firm catheter tip into the restraining wall, and self-obstruction of the balloon deflation outlet by the inflated baloon. Many of these problems were clinically confirmed by careful in vivo observations and by evidence collected from the nine cases of rectal injury. A series of practical prophylactic procedures are recommended.
回顾了9例此前未报告过的由钡剂灌肠检查导致的直肠损伤。在每一例中，损伤均与直肠球囊充气有关。对临床资料的分析表明，球囊导管尖端的某些机械性能可能会将机械应力传递至直肠壁，并导致所观察到的损伤。对活体直肠球囊进行仔细的压力测量评估表明，患者之间显著的解剖差异可能具有临床重要性。进一步的实验台研究揭示了许多市售直肠球囊导管存在不良的机械性能。这些机械问题包括顺应性低、充气不对称、坚硬的导管尖端向限制壁的强烈侧向和向前移位，以及充气后的球囊使球囊放气出口自阻塞。其中许多问题通过仔细的活体观察以及从9例直肠损伤病例中收集的证据得到了临床证实。推荐了一系列实用的预防措施。
