[Radiological diagnosis of constipation and anal incontinence caused by changes in the pelvic floor and anal sphincter. Our experience with 38 patients with constipation with or without incontinence].
Rectal constipation, anal incontinence and constipation combined with incontinence, are often caused by organic or simply functional changes in the pelvic floor and sphincteric apparatus. Therefore morphological as well as manometric and electromyographic studies of these anatomical parts are required. This is possible by combining two techniques: Intestinal Transit Time (ITT) and Defecatory Proctogram with Balloon (DPB). Personal experience of 38 patients with constipation with or without incontinence is reported. The results lead to the following conclusions: 1) ITT is a simple and non-invasive radiological technique that provides us with objective evidence of an impairment, i.e. constipation, whose symptoms are often only subjective; especially it allows us to identify rectal constipation, that can be caused by impairment of the anal sphincteric apparatus. 2) Using an uroprophylactic with a collar that adapts to the size of the anal duct, DPB always permits visualisation of the duct with good representation of the recto-anal angle, whose changes may be the expression of organic or only functional impairments of the anal sphincteric apparatus. Increasing use of the two radiological techniques is therefore recommended in the diagnosis of alterations of the pelvic floor or anal sphincter.
Parrella
R E
RE
Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma.
Brizi
M G
MG
Giannasio
T
T
Natale
L
L
Posi
G
G
Vulpio
C
C
D001003:Anal Canal / Q000503:physiopathology*; D003248:Constipation / Q000150:complications* / Q000000981:diagnostic imaging*; D003672:Defecation; D005242:Fecal Incontinence / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D010528:Peristalsis; D011859:Radiography
La diagnosi radiologica nella stipsi e nell'incontinenza anale secondarie ad alterazioni del pavimento pelvico e dell'apparato sfinteriale dell'ano. Nostra esperienza su 38 pazienti con stipsi associata o meno ad incontinenza.