Contrast medium gel for marking vaginal position during defecography.
ABSTRACT A tampon soaked with contrast medium, which had been inserted into the vagina as part of standard defecography procedure, obscured signs of anterior rectocele and rectal intussusception in a 34-year-old woman. A contrast medium gel for marking vaginal position was formulated, and postsurgical examination with use of the gel revealed improved rectal function and no intussusception. The gel provided excellent contrast without obscuring important diagnostic information.
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ABSTRACT: Interpretation of evacuation proctography (EP) images is reliant on robust normative data. Previous studies of EP in asymptomatic subjects have been methodologically limited. The aim of this study was to provide parameters of normality for both genders using EP. EP was prospectively performed on 46 healthy volunteers (28 females). Proctograms were independently analysed by two reviewers. All established and some new variables of defaecatory structure and function were assessed objectively: anorectal dimensions, anorectal angle changes, evacuation time, percentage contrast evacuated and incidence of rectal wall morphological 'abnormalities'. Normal ranges were calculated for all main variables. Mean end evacuation time was 88 sec (CI 63-113) in males and 128 sec (98-158) in females; percentage contrast evacuated was 71% (63-80) in males and 65% (58-72) in females. 26 / 28 female subjects (93%) had a rectocoele with a mean depth of 2.5 cm (upper limit 3.9 cm). Recto-rectal intussusception was a finding in 9 subjects (approximately 20% of both genders); however, recto-anal intussusception was not observed. Only rectal diameter differed significantly between genders. Qualitatively, three patterns of evacuation were present. This study defines normal ranges for anorectal dimensions and parameters of emptying as well as the incidence and characteristics of rectal wall 'abnormalities' observed or derived from EP. These ranges can be applied clinically for subsequent disease comparison. This article is protected by copyright. All rights reserved.Colorectal Disease 02/2014; 16(7). DOI:10.1111/codi.12595 · 2.02 Impact Factor
Article: Letters to the editorAbdominal Imaging 05/1995; 20(3). DOI:10.1007/BF00200418 · 1.73 Impact Factor
Article: Digital subtraction in defecography.[Show abstract] [Hide abstract]
ABSTRACT: Defecography is commonly used in investigation of pelvic floor and anorectal dysfunction, and incorporates measurement of pelvic floor movement during various maneuvers. These measurements are usually referenced to bony landmarks, particularly the ischial tuberosities. These bony landmarks may be difficult to visualize; theoretically, the use of digital subtraction in filming defecography studies should eliminate the need to pinpoint bony position. We filmed 25 defecogram studies in both non-subtracted and subtracted formats, and interpreted each study blindly, subsequently comparing diagnoses and measurements. Subtraction was of limited benefit in only one case, was impossible in one case, added no useful information in 18 cases, and hindered visualization of abnormalities in five cases. Because of the multiple overlapping densities and the inability to restrict patient movement, digital subtraction is unhelpful in defecography.Abdominal Imaging 05/1995; 20(3):245-7. DOI:10.1007/BF00200406 · 1.73 Impact Factor