Defecographic Measurements of Rectal Intussusception and Prolapse in  Patients and in Asymptomatic Subjects

Pomerri, Fabio; Zuliani, Monica; Mazza, Cecilia; Villarejo, Felipe; Scopece, Angela

doi:10.2214/ajr.176.3.1760641

Cited by 60 publications

(31 citation statements)

References 29 publications

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“…Studies have shown that this finding is usually missed or underestimated at MR defecography because of the lack of the gravity effect and the mucosa not well depicted [47][48][49]. These are easily diagnosed by DCP.…”

Section: Discussionmentioning

confidence: 99%

Pelvic floor disorders: what’s the best test?

Silva

Maglinte

2013

Abdom Imaging

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Pelvic floor dysfunctions represent a common health problem affecting particularly post-menopausal women impacting significantly the quality of life. A large number of these patients suffer for many years without proper treatment often due to the lack of objective findings necessary to plan proper treatment. Because abnormalities of the different pelvic compartments are frequently associated, thorough diagnostic characterization of how many compartments are affected is paramount in order to plan the management approach that can include a multidisciplinary surgical approach. This pictorial essay will review the different imaging methods used for the characterization of these disorders, how to do them and its rationale providing a clinically understandable interpretation with clinical correlates and a correlation between fluoroscopic and MR defecography in order to illustrate the strengths and shortcomings of each. The need to use a standardized, reliable, and clinically understandable method of quantification has become more obvious in the last decades with the increasing rate of scientific and professional interchanges. A review of the grading systems used to convey the imaging findings also highlights the importance of using a standardized tool for comparing and communicating clinical findings understandable to referring physicians with proven inter-observer and intra-observer agreement of the examinations.

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Section: Discussionmentioning

confidence: 99%

Pelvic floor disorders: what’s the best test?

Silva

Maglinte

2013

Abdom Imaging

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“…In patients with RAI failing conservative treatment, surgery is considered 5,6) . Rectal intussusception (RI) has been seen in asymptomatic individuals at proctography 4) , and the clinical and pathological significance of this finding has been questioned 7) . Recent studies have addressed the differences in anorectal morphology during defecation between patients with evacuation disorder and asymptomatic individuals, and intussusception thickness was significantly greater in patients with symptomatic RI 7,8) .…”

Section: Introductionmentioning

confidence: 99%

“…Rectal intussusception (RI) has been seen in asymptomatic individuals at proctography 4) , and the clinical and pathological significance of this finding has been questioned 7) . Recent studies have addressed the differences in anorectal morphology during defecation between patients with evacuation disorder and asymptomatic individuals, and intussusception thickness was significantly greater in patients with symptomatic RI 7,8) . According to the grading system for mucosal prolapse and intussusception described by Shorvon et al 4) , noncircumferential recto-rectal infolding of 3 mm or greater is fit for grade 3, but RAI which is allocated to grade 4 or 5, is circumferential infolding.…”

Section: Introductionmentioning

confidence: 99%

Proctographic findings and symptoms in patients with anterior rectoanal intussusception

Tsunoda

Takahashi

Hayashi

et al. 2017

J Anus Rectum Colon

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Abstract:Objectives: Rectoanal intussusception (RAI) is a common finding on defecography in patients with defecation disorders. This study aimed to compare the proctographic findings and symptoms between patients with anterior RAI and those with circular RAI. Methods: We included 208 patients who were diagnosed as having RAI on defecography. Anorectal function was evaluated using Constipation Scoring System (CSS) and Fecal Incontinence Severity Index (FISI). Results: Twenty-four patients had anterior RAI and 184 had circular RAI. While the anterior intussusception descent or pelvic floor descent was significantly smaller in patients with anterior RAI than those with circular RAI [14.3 vs. 18.5 mm, p=0.004; 12.4 vs. 21.6 mm, p= 0.005], there were no significant differences in incidences of obstructed defecation (OD) and fecal incontinence (FI) between the groups. Sixteen patients with anterior RAI and 137 patients with circular RAI had OD. There was no significant difference in the CSS scores between the groups. Twelve patients with anterior RAI and 108 patients with circular RAI had FI. No significant difference in the FISI scores between the groups. Conclusions: Approximately one tenth of the whole RAI was anterior in location, and symptoms in patients with anterior RAI were similar to those with circular RAI.

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“…Rectal intussusception (RI) has been seen in asymptomatic individuals at proctography [4], and the clinical and pathological significance of this finding has been questioned [7]. Recent studies have addressed the differences in anorectal morphology during defecation between patients with evacuation disorder and asymptomatic individuals, and intussusception thickness was significantly greater in patients with symptomatic RI [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have addressed the differences in anorectal morphology during defecation between patients with evacuation disorder and asymptomatic individuals, and intussusception thickness was significantly greater in patients with symptomatic RI [7,8].…”

Section: Introductionmentioning

confidence: 99%

Anterior intussusception descent during defecation is correlated with the severity of fecal incontinence in patients with rectoanal intussusception

et al. 2016

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Defecographic Measurements of Rectal Intussusception and Prolapse in Patients and in Asymptomatic Subjects

Abstract: Our findings suggest that dynamic evacuation radiology contributes to making a differential diagnosis between rectal intussusception and mucosal folds in the rectum.

Cited by 60 publications

References 29 publications

Pelvic floor disorders: what’s the best test?

Pelvic floor disorders: what’s the best test?

Proctographic findings and symptoms in patients with anterior rectoanal intussusception

Anterior intussusception descent during defecation is correlated with the severity of fecal incontinence in patients with rectoanal intussusception

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