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Ultrasonographic patterns in patients with obstructed defaecation.
L Brusciano1, P Limongelli, M Pescatori
1First Division of General and Gastrointestinal Surgery, School of Medicine, Second University of Naples, Naples, Italy. luigibrusciano@tin.it
International Journal of Colorectal Disease
|January 12, 2007
Summary
Anal ultrasound effectively identifies abnormalities in obstructed defecation (OD) patients, including anismus and rectal prolapse. This non-invasive imaging provides valuable diagnostic information for functional anorectal disorders.
Area of Science:
- Gastroenterology
- Medical Imaging
- Pelvic Floor Disorders
Background:
- Anal ultrasound is established for organic anorectal lesions but its utility in functional disorders remains debated.
- Obstructed defecation (OD) is a functional disorder impacting defecation, with unclear diagnostic pathways for certain aspects.
- Assessing the role of advanced ultrasound techniques in diagnosing functional defecatory disorders is crucial.
Purpose of the Study:
- To evaluate the effectiveness of anal, vaginal, and dynamic perineal ultrasonography in identifying abnormalities in patients with obstructed defecation (OD).
- To compare ultrasonographic findings in OD patients with those of healthy controls.
- To assess the diagnostic performance of ultrasonography for conditions like anismus, rectal intussusception, and mucosal prolapse.
Main Methods:
- Retrospective analysis of 92 OD patients and 22 healthy controls.
- Utilized endoanal, endovaginal, and dynamic perineal ultrasound (US) with rotating and linear probes.
- Correlated US findings with digital exploration, manometry, and defaecography, using defaecography as the gold standard for intussusception and rectocele.
Main Results:
- Higher incidence of anismus (48-53%) and rectal internal mucosal prolapse (51-62%) in OD patients compared to controls (21-22% and 9-13.6%, respectively).
- Anal US demonstrated 100% sensitivity and specificity for rectal internal mucosal prolapse and high accuracy for intussusception.
- Ultrasonography identified other lesions like solitary rectal ulcer, rectocele, enterocele, and sphincter damage in OD patients.
Conclusions:
- Anal, vaginal, and dynamic perineal ultrasonography are valuable tools for diagnosing abnormalities in patients with obstructed defecation (OD).
- These non-invasive imaging modalities can confirm various conditions contributing to OD.
- Further research is needed to define the precise role of these ultrasound techniques within the diagnostic algorithm for OD.
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