PURPOSE: To evaluate the use of simultaneous defecography and peritone
ography (defecoperitoneography) in patients with an unexplained wideni
ng of the rectovaginal space noted at defecography. MATERIALS AND METH
ODS: Twenty-two patients with unexplained widening of the rectovaginal
space noted at defecography were studied with defecoperitoneography.
Defecoperitoneography was a combination of defecography and peritoneog
raphy with water-soluble contrast medium administered intraperitoneall
y. RESULTS: The outline and movements of the peritoneum and alteration
s in the pelvic peritoneal cavity could be visualized with defecoperit
oneography during the dynamic act of defecation. Unexplained widening
of the rectovaginal space was completely due to a peritoneocele in 14
patients and partially due to a peritoneocele in six patients. In two
patients, there was no peritoneocele. Only nine of 22 patients had bow
el in the unexplained widening (enterocele). Three patients had a rect
al peritoneocele; six, a septal peritoneocele; one, a vaginal peritone
ocele; and 10, a combination of these findings. CONCLUSION: Visualizat
ion of the pelvic floor with defecoperitoneography is improved compare
d with visualization with defecography alone.