PERITONEOCELE - VISUALIZATION WITH DEFECOGRAPHY AND PERITONEOGRAPHY PERFORMED SIMULTANEOUSLY

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.