[Defecography study of outpouchings of the external wall of the rectum: posterior rectocele and ischio-rectal hernia].
OBJECTIVE
To report the clinical and defecographic features of posterior rectal wall outpouchings, i.e., posterior rectocele and ischiorectal hernia.


METHODS
Sixty-six patients with posterior rectal wall outpouching (61 with posterior rectocele and 5 with ischiorectal hernia) were selected among the patients examined in the last two years for defecation disturbance. All patients underwent physical examination, rectoscopy and videodefecography.


RESULTS
Posterior rectal wall outpouchings were detected at physical examination in 28 patients and at rectoscopy in 9 patients. Posterior rectocele, more frequent and bigger in men, was usually demonstrated at videodefecography as an outpouching of the lower portion of posterior rectal wall: this finding was visible only in the dynamic phases in 51 patients while it was seen also at rest in 10 patients. In 52 patients, posterior rectocele was associated with other abnormalities--i.e., anterior rectocele (64%), puborectal muscle syndrome (38%), descending perineum (33%), mucosal prolapse (33%) and intussusception (20%). An ischiorectal hernia, defined as a posterolateral ampullar outpouching deeper than 4 cm and already visible at rest, was identified in 5 patients. Descending perineum and anterior rectocele were the most common associated disorders.


CONCLUSIONS
We report the clinical and defecographic features of these rectal abnormalities and stress the importance of videodefecography in the real-time study of these morphofunctional disorders.
Grassi
R
R
Istituto di Scienze Radiologiche, Facoltà di Medicina, Università Federico II, Napoli.
Pomerri
F
F
Habib
F I
FI
Catalano
O
O
Bressanin
F
F
Rotondo
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003672:Defecation; D005260:Female; D006547:Hernia / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012002:Rectal Diseases / Q000000981:diagnostic imaging*; D012007:Rectum / Q000000981:diagnostic imaging*
Studio defecografico delle estroflessioni della parete posteriore del retto: rettocele posteriore ed ernia ischio-rettale.