[Endoanal ultrasonography, defecography, and enema of the colon in the radiologic study of incontinence].
In the last 3 years, the authors examined 564 patients with disturbed anorectal function. Of 41 incontinent subject in this series, 30 were retrospectively analyzed to assess the diagnostic contribution of double contrast barium enema, defecography and endoanal sonography. The authors propose a classification of fecal incontinence based on imaging findings: indeed, rectal incontinence can be distinguished from pelvic and sphincteral incontinence. Large bowel enema and defecography are the examinations of choice if rectal incontinence is suspected on the basis of clinical history and possible endoscopic, manometric and electromyographic findings. Defecography is suggested if pelvic incontinence is suspected, while anal endosonography is the exam of choice in case of suspected sphincteral incontinence. Especially thanks to the recent availability of the latter technique, today radiologists can directly visualize the anal sphincteral apparatus and its lesions, yielding objective evidence of this type of incontinence too. The authors report on both limitations and indications of each diagnostic method and conclude by stressing the fundamental role diagnostic imaging plays today in the study of this disorder.
Grassi
R
R
Istituto di Scienze Radiologiche, Facoltà di Medicina, Università Federico II, Napoli.
Rotondo
A
A
Catalano
O
O
Amitrano
M
M
Vallone
G
G
Gargano
V
V
Fanucci
A
A
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003106:Colon / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003672:Defecation; D004733:Enema; D005242:Fecal Incontinence / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D014463:Ultrasonography
Ecografia endoanale, defecografia e clisma del colon nello studio radiologico dell'incontinenza.