McGee S G, Bartram C I
Department of Radiology, Saint Mark's Hospital, London, United Kingdom.
Abdom Imaging. 1993;18(2):136-40. doi: 10.1007/BF00198050.
Intra-anal intussusception was diagnosed in eight of 39 patients on evacuation proctography. Posteroanterior views revealed prolapse of the infolded rectum into the anal canal on staining in seven of eight patients, associated with splaying open of the anal canal and sudden distal movement of the fold during prolapse. Similar changes were seen in four of 31 patients in whom intussusception had not been diagnosed on lateral evacuation proctography. The pattern of the collapsed rectum was assessed for fold length, thickness, and angulation in relation to the midline of the rectum. Infoldings that prolapsed were closer to the anorectal junction on stress (mean 14.6: 42.4 mm, p < 0.0001) showed greater change in height between rest and strain (28.8: 14.6 mm, p < 0.05) and became more acutely angled during straining (41.9: 5.3 degrees, p < 0.01). Intra-anal intussusception may be missed in 33% (four of 12 patients) on routine evacuation proctography. Posteroanterior stress proctography is a simple supplementary examination to validate intussusception.
39例患者中，8例在排粪造影时被诊断为肛管内套叠。8例患者中有7例在染色后的前后位片上显示折叠的直肠脱垂至肛管，伴有肛管张开以及脱垂过程中褶皱突然向远侧移动。31例在侧位排粪造影时未诊断出套叠的患者中，有4例出现了类似变化。评估了塌陷直肠的形态，包括褶皱长度、厚度以及相对于直肠中线的角度。脱垂的褶皱在用力时更靠近肛管直肠交界处（平均14.6: 42.4 mm，p < 0.0001），在静息和用力时高度变化更大（28.8: 14.6 mm，p < 0.05），并且在用力时角度变得更尖锐（41.9: 5.3度，p < 0.01）。在常规排粪造影中，33%（12例患者中的4例）可能漏诊肛管内套叠。前后位用力排粪造影是一种简单的补充检查，用于证实套叠。
