S. Bremmer et al., PELVIC ANATOMY AND PATHOLOGY IS INFLUENCED BY DISTENSION OF THE RECTUM - DEFECOPERITONEOGRAPHY BEFORE AND AFTER RECTAL FILLING WITH CONTRAST-MEDIUM, Diseases of the colon & rectum, 40(12), 1997, pp. 1477-1483
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.