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Peritoneocele and enterocele. Formation and transformation during rectal evacuation as studied by means of
S Bremmer1, A Mellgren, B Holmström
1Department of Diagnostic Radiology, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
Purpose:
To study, by means of defaeco-peritoneography, the formation and transformation of the peritoneocele, with and without an enterocele, during rectal evacuation.
Material And Methods:
Forty-six patients with a peritoneocele at defaeco-peritoneography were selected for the study, and examined at three different stages: 1) at the start with a contrast-filled rectum; 2) at maximum straining; and 3) at rest after rectal evacuation.
Results:
Fourteen patients had a peritoneocele at the start. These peritoneoceles were largest at maximum straining and were all still present at rest after rectal evacuation. In 32 patients defaeco-peritoneography was regarded as normal at the start. At maximum straining these patients developed a peritoneocele and 20 of these were still present after rectal evacuation. No enterocele was seen at the start. At maximum straining 21 patients developed an enterocele and 15 of these were still present after rectal evacuation. Liquid in varying amounts was found in the peritoneoceles.
Conclusion:
The present study demonstrated that peritoneoceles were present at different stages of the defaeco-peritoneographic investigations. Peritoneoceles were most frequent and largest at maximum straining. An enterocele was present in half of the peritoneoceles at maximum straining, but never at the start. Liquid was often present in the peritoneoceles.