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Peritoneocele. A radiological study with defaeco-peritoneography

S Bremmer1

  • 1Karolinska Institute, Danderyd Hospital, Sweden.

Acta Radiologica. Supplementum
|March 6, 1998
PubMed
Summary
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Defaecography can reveal unexplained widening of the rectovaginal space, often caused by a peritoneocele. This combined defaecography and peritoneography technique accurately diagnoses pelvic floor disorders like rectal intussusception and enterocele.

Area of Science:

  • Pelvic floor imaging
  • Gastroenterology
  • Radiology

Background:

  • Defaecography is crucial for evaluating defecation disorders.
  • Unexplained widening of the rectovaginal space is a common finding requiring further investigation.
  • Peritoneocele, an extension of the pouch of Douglas, is a potential cause of this widening.

Purpose of the Study:

  • To investigate the cause of unexplained widening of the rectovaginal space observed during defaecography.
  • To evaluate the utility of a combined defaecography and peritoneography technique (defaeco-peritoneography) in diagnosing pelvic floor pathologies.
  • To characterize the types and prevalence of peritoneoceles and their association with other pelvic floor disorders.

Main Methods:

  • A retrospective analysis of 2816 defaecography reports identified common findings and unclear cases.

Related Experiment Videos

  • A novel technique, defaeco-peritoneography, was developed and applied to patients with unexplained rectovaginal space widening.
  • Studies included dynamic imaging during defecation and comparison of images with and without rectal contrast.

    • Main Results:

    • Defaeco-peritoneography identified peritoneocele as the cause of unexplained rectovaginal widening in most cases (20/22).
    • Peritoneoceles were classified into vaginal, septal, and rectal types, often associated with enteroceles.
    • Patients with rectal intussusception or rectal prolapse consistently showed a rectal peritoneocele.

    Conclusions:

    • Defaeco-peritoneography is an effective method for diagnosing peritoneoceles and associated pelvic floor abnormalities.
    • The presence of peritoneocele is strongly linked to conditions like rectal intussusception and rectal prolapse.
    • A standardized protocol including pre-contrast imaging is recommended for comprehensive defaecography evaluation.