Nielsen M B, Buron B, Christiansen J, Hegedüs V
Department of Radiology, Glostrup Hospital, University of Copenhagen, Denmark.
Dis Colon Rectum. 1993 Sep;36(9):806-9. doi: 10.1007/BF02047375.
The aim of this study was to examine defecographic findings in patients with anal incontinence and constipation and to compare these findings with rectal emptying.
One hundred seventy-five preoperative defecographies documented on videotape in patients with either anal incontinence or constipation were retrospectively reviewed. The examinations were evaluated with respect to anatomic abnormalities of the rectum or anal canal. The results were compared with a semi-quantitative assessment of rectal emptying as it appeared on the video sequence after one minute of strain.
Anatomic abnormalities were found equally in incontinent and constipated patients, except for failure to open the anal canal, which was found only in constipated patients. Rectal intussusception was the most frequent finding. Abnormal defecograms were found in both sexes. Enteroceles, sigmoidoceles, and large rectoceles were found only in women. The presence of intussusception, lacking relaxation of the puborectalis muscle, and rectocele did not correlate with poor rectal emptying. Poor rectal emptying was also found in 19 of 58 patients with normal defecograms.
Anatomic abnormalities of the rectum may be demonstrated independently of the clinical symptoms and are not always correlated to impaired rectal emptying. Since they may also be found in healthy controls, surgical correction of these abnormalities should be considered only with great caution.
本研究旨在检查大便失禁和便秘患者的排粪造影结果，并将这些结果与直肠排空情况进行比较。
回顾性分析175例术前记录在录像带上的大便失禁或便秘患者的排粪造影。对检查结果进行直肠或肛管解剖异常方面的评估。将结果与用力1分钟后视频序列中出现的直肠排空半定量评估结果进行比较。
除肛管未打开仅在便秘患者中发现外，大便失禁和便秘患者的解剖异常发生率相同。直肠套叠是最常见的发现。男女均发现有异常的排粪造影。肠膨出、乙状结肠膨出和大的直肠膨出仅在女性中发现。套叠的存在、耻骨直肠肌缺乏松弛以及直肠膨出与直肠排空不良无关。58例排粪造影正常的患者中，19例也存在直肠排空不良。
直肠解剖异常可能独立于临床症状出现，且并不总是与直肠排空受损相关。由于在健康对照中也可能发现这些异常，因此仅在非常谨慎的情况下才应考虑对这些异常进行手术矫正。
