Halligan S, Bartram C I
Department of Radiology, St. Mark's Hospital, London, United Kingdom.
Dis Colon Rectum. 1995 Jul;38(7):764-8. doi: 10.1007/BF02048038.
This study was designed to determine whether rectocele size and contrast retention are significant.
Evacuation proctography and simultaneous intrarectal pressure measurements from a small, noncompliant balloon catheter were performed in three matched groups of 11 constipated female patients with rectoceles, rectoceles and contrast trapping of > 10 percent, and no rectocele. Computerized image analysis was used to measure rectocele area and evacuation.
In the two groups with rectoceles, there was no significant difference in rectocele area or width pre-evacuation. The anorectal angle, pelvic floor descent, maximum anal canal width, evacuation time or completeness, maximum and distal intrarectal pressure, or need to digitate did not differ significantly between the groups. In seven patients with barium trapping (64 percent) the intrarectal pressure dropped abruptly as the balloon entered the rectocele, suggesting that trapping results from sequestration into the vagina, closing part of the rectocele from the normal intrarectal pressure zone.
Because no impairment of evacuation appears to be associated with either a large rectocele or trapping, these evacuation problems should not be directly attributed to these proctographic findings.
本研究旨在确定直肠膨出的大小和造影剂潴留是否具有重要意义。
对三组各11名患有直肠膨出、直肠膨出且造影剂潴留>10%以及无直肠膨出的便秘女性患者进行排粪造影，并通过一个小型、顺应性差的球囊导管同时测量直肠内压力。采用计算机图像分析来测量直肠膨出面积和排空情况。
在两组患有直肠膨出的患者中，排空前直肠膨出面积或宽度无显著差异。两组之间的肛管直肠角、盆底下降、肛管最大宽度、排空时间或完整性、直肠内最大和远端压力，或是否需要手指辅助排便均无显著差异。在7名有钡剂潴留的患者（64%）中，当球囊进入直肠膨出时，直肠内压力突然下降，这表明潴留是由于造影剂被隔离到阴道内，使直肠膨出的一部分与正常直肠内压力区域隔开所致。
由于无论是大的直肠膨出还是造影剂潴留似乎都与排空功能受损无关，因此这些排空问题不应直接归因于这些造影检查结果。
