Defecography and proctography. Results of 744 patients.
OBJECTIVE
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.


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).


CONCLUSIONS
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.
Agachan
F
F
Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309, USA.
Pfeifer
J
J
Wexner
S D
SD
D000368:Aged; D001466:Barium Sulfate; D003248:Constipation / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003672:Defecation / Q000502:physiology*; D004733:Enema; D005242:Fecal Incontinence / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007443:Intussusception / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012002:Rectal Diseases / Q000000981:diagnostic imaging*; D012005:Rectal Prolapse / Q000000981:diagnostic imaging*; D012007:Rectum / Q000000981:diagnostic imaging; D014743:Videotape Recording
D003287:Contrast Media; D001466:Barium Sulfate