Sentovich S M, Rivela L J, Thorson A G, Christensen M A, Blatchford G J
Department of Surgery, New England Deaconess Hospital, Boston, Massachusetts, USA.
Dis Colon Rectum. 1995 Sep;38(9):912-5. doi: 10.1007/BF02049724.
We sought to evaluate a new diagnostic technique for the identification of rectal and pelvic floor pathology in patients with obstructed defecation, pelvic fullness/prolapse, and/or chronic intermittent pelvic floor pain.
Thirteen symptomatic women with either a nondiagnostic physical examination or nondiagnostic dynamic proctography (DPG) were studied. After placement of intraperitoneal and intrarectal contrast material, resting and straining pelvic x-rays were obtained in all patients, and defecation was videotaped using fluoroscopy.
Simultaneous DPG and peritoneography identified clinically suspected and unsuspected enteroceles in 10 of the 13 patients studied. An enterocele or other pelvic floor hernia was ruled out by the technique in three of the women studied. Rectoceles and rectal prolapse that were identified during physical examination were confirmed by DPG with peritoneography. Simultaneous DPG and peritoneography also gave a qualitative assessment of the severity and clinical significance of the identified pelvic floor disorders. Results of simultaneous DPG and peritoneography affected operative treatment planning in 85 percent of patients studied.
Simultaneous DPG and peritoneography identifies both rectal and pelvic floor pathology and provides a qualitative assessment of pelvic floor pathology severity, which allows for better treatment planning in selected patients with obstructed defecation and pelvic prolapse.
我们试图评估一种新的诊断技术，用于识别排便梗阻、盆腔胀满/脱垂和/或慢性间歇性盆腔疼痛患者的直肠和盆底病变。
对13名有症状的女性进行了研究，这些女性要么体格检查未明确诊断，要么动态直肠造影（DPG）未明确诊断。在注入腹腔内和直肠内造影剂后，对所有患者进行静息和用力时的盆腔X光检查，并使用荧光透视对排便过程进行录像。
在13名接受研究的患者中，同时进行的DPG和腹膜造影在10名患者中发现了临床疑似和未被怀疑的肠膨出。在3名接受研究的女性中，该技术排除了肠膨出或其他盆底疝。体格检查中发现的直肠膨出和直肠脱垂通过DPG联合腹膜造影得到了证实。同时进行的DPG和腹膜造影还对所发现的盆底疾病的严重程度和临床意义进行了定性评估。在85%的接受研究的患者中，同时进行的DPG和腹膜造影结果影响了手术治疗方案的制定。
同时进行的DPG和腹膜造影可识别直肠和盆底病变，并对盆底病变的严重程度进行定性评估，这有助于为选定的排便梗阻和盆腔脱垂患者制定更好的治疗方案。
