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Defecography and proctography

Results of 744 patients

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Radiographic imaging of dynamic changes within the pelvic cavity and rectum during evacuation has been recognized as a valuable method of assessment. This study was designed to assess the incidence and clinical significance of defecographic findings in patients with possible evacuation disorders. MATERIALS AND METHODS: All defecographic studies were reviewed by a single colorectal surgeon familiar with patients' histories and physical findings. RESULTS: Between July 1988 and July 1995, 744 patients (566 females and 178 males) with a mean age of 63.5 (range, 12–95) years had defecographic and proctographic examination. Four hundred forty-six (60 percent) patients were diagnosed who complained of constipation, 123 (16.5 percent) of fecal incontinence, 42 (5.6 percent) of rectal prolapse, 82 (11 percent) of rectal pain, and 51 (6.9 percent) had a combination of more than one of these diagnoses. Although 93 (12.5 percent) of these evaluations were considered normal, 61 (8 percent) revealed rectal prolapse, 191 (25.7 percent) rectocele, 82 (11 percent) sigmoidocele, and 94 (12.6 percent) intussusception; in 223 (30 percent) patients, a combination of these findings was noted. Patients with paradoxical puborectalis contraction had an extremely high frequency of constipation compared with other symptoms ( P <0.0001). CONCLUSION: Defecography can reveal abnormalities in the majority of patients with evacuatory disorders. There was a high incidence of rectocele, sigmoidocele, and intussusception. Care must be taken not to treat patients strictly based on radiographic findings.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, 33309, Fort Lauderdale, Florida

    Feran Agachan M.D., Johann Pfeifer M.D. &  Steven D. Wexner M.D.

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  1. Feran Agachan M.D.
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  2. Johann Pfeifer M.D.
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  3. Steven D. Wexner M.D.
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Agachan, F., Pfeifer, J. & Wexner, S.D. Defecography and proctography. Dis Colon Rectum 39, 899–905 (1996). https://doi.org/10.1007/BF02053989

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