PELVIC ANATOMY AND PATHOLOGY IS INFLUENCED BY DISTENSION OF THE RECTUM - DEFECOPERITONEOGRAPHY BEFORE AND AFTER RECTAL FILLING WITH CONTRAST-MEDIUM

PURPOSE: The aim of the present study was to evaluate how distention o f the rectum with contrast medium at defecoperitoneography affected pe lvic anatomy, i.e., position, form, and size, of organs and pouch of D ouglas. PATIENTS AND METHODS: Twenty-six female patients with a perito neocele at defecoperitoneography were selected for the present study. Radiographs taken at the start, before, and after filling the rectum w ith contrast medium were compared. RESULTS: There was an obvious chang e in the position of the organs in the pelvis when the rectum was dist ended with contrast medium. The peritoneocele disappeared completely i n 19 of the patients and was reduced in size in the remaining 7 patien ts, and the enterocele disappeared completely in 13 patients. The smal l bowel and vaginal portion of the uterus moved cranially. CONCLUSIONS : A distended rec turn may conceal existing pathology, such as periton eocele and enterocele, at defecoperitoneography. Defecoperitoneography should, therefore, include a radiograph before the rectum is filled. This radiograph shows the habitual anatomy of the patient in the sitti ng position and may demonstrate pathologic findings.