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[National working team report on defecography]

V Piloni1, N Genovesi, R Grassi

  • 1Istituto Geriatrico, Dipartimento di Radiologia, Fermo (Ascoli Piceno).

La Radiologia Medica
|June 1, 1993
PubMed
Summary

Defecography experts established consensus on test demand and indications. Key findings highlight the anorectal angle and pubococcygeal line distance for diagnosing obstructed defecation and incontinence.

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Area of Science:

  • Gastroenterology
  • Pelvic Floor Imaging
  • Diagnostic Imaging

Background:

  • Defecography is a specialized imaging technique used to evaluate defecation disorders.
  • There was a need to quantify the demand for defecography and establish expert consensus on its diagnostic utility.
  • Obstructed defecation and fecal incontinence are common indications for defecography.

Purpose of the Study:

  • To quantify the demand for defecography exams.
  • To develop a consensus report on the diagnostic value of defecography among national experts.
  • To identify key imaging variables with high discriminatory capabilities for specific defecation disorders.

Main Methods:

  • A questionnaire was distributed to five national defecography experts.
  • Data on exam demand, indications, and diagnostic variables were collected.

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  • Statistical analysis was performed to compare patient groups and controls.

    • Main Results:

    • The demand for defecography is estimated at 2-8 exams per week.
    • Obstructed defecation, with or without constipation, is the most frequent indication (70%).
    • Significant differences in anorectal angle (ARA) and pubococcygeal line (PCL) distance were observed in patients with obstructed defecation and incontinence compared to controls.
    • Defecography demonstrated high sensitivity (97%) and positive predictive value (98%) for rectocele, and high specificity (92%) for anal gaping.

    Conclusions:

    • Defecography is a valuable tool for diagnosing defecation disorders, particularly obstructed defecation and incontinence.
    • Specific measurements like ARA and PCL are crucial for accurate diagnosis.
    • Expert consensus supports the utility of defecography in clinical practice, with high diagnostic accuracy for specific conditions like rectocele and anal gaping.