直肠内脱垂的X线造影诊断

RADIOGRAPHY DIAGNOSIS OF INTERNAL RECTAL PROLAPSE

现行排粪造影不能满足指导直肠内脱垂诊治的需要,报道作者设计的盆腔造影结合排粪造影的应用结果:在82例直肠内脱垂中,50例有直肠内脱垂征象、而盆底腹膜正常者为直肠粘膜脱垂,其中26例伴异常会阴下降;32例有直肠内脱垂征象、盆底腹膜随直肠前壁降人套叠鞘部、并构成直肠壁内疝疝囊者为直肠全层套叠,6例疝囊上口敞开者术中证实有内容物疝人,20例伴异常会阴下降。故认为排粪造影结合盆腔造影是区分粘膜脱垂与全层套叠、诊断直肠内脱垂伴发的直肠壁内疝等盆底疝的直观可靠方法。

Current defecography cannot meet satisfactorily the requirements of the diagnosis and treatment of internal rectal prolapse (IRP). The defeco-pelvicography used in this investiga-tion was designed by the authors. The results were as follows: Among the 82 patients with IRP, 52 patients had rectal mucosal prolapse (RMP), without any changes of the pelvic floor peritoneal cul-de-sac; 26 patients had abnormal descent of the perineum; 32 patients with full thichness rec-tal intussusception (FTRI) had abnormal patients with full thichness rectal intussusception (FTRI) had abnormal descent of the pelvic floor peritoneal cul-de-sac, forming the internal herni-ated sac of the rectal wall 56 patients were confirmed to have contents in the sacs; and 20 patients had abnormal descent of the perineum. Our results indicate that defeco-pelvicography is a reliable means in distinguishing RMP from FTRI, and in demonstrating a concomitant internal herniated sac of the rectal wall.