Document Detail


Role of dynamic magnetic resonance imaging in management of obstructed defecation case series.
MedLine Citation:
PMID:  20219700     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Surgical treatment of obstructed defecation (OD) carries frequent recurrences. The aim of the study was to evaluate the role dynamic magnetic resonance imaging defecography, and to elucidate the underlying anatomic and pathophysiologic background of pelvic floor disorders in these patients in order to minimize failures. PATIENTS AND METHODS: Forty consecutive constipated patients with OD symptoms (31 females) with mean age 48.15+/-14.29 years. They underwent perineal examination, proctoscopy, anorectal manometry and Dynamic MRI defecography. The different pelvic floor morphology was recorded. The type and outcome of treatment whether conservative or surgical were also recorded. RESULTS: The dynamic MRI of the pelvic floor showed 23 patients with descending perineum, 32 rectoceles (28 females), 12 cystoceles (10 females), 6 enteroceles (4 females), 18 intussusceptions (14 females), and 7 dyskinetic puborectalis muscle (3 females). The diagnosis of combined pelvic floor disorders with dynamic MRI defecography was consistent with clinical results in 70% and there were additional diagnostic parameters in 30% of patients. Dynamic MRI findings changed treatment decision in 8 patients 20% with surgical treatment performed in 25 patients (8 stappled trans-anal rectal resection, 11 trans-anal Delorme's, 6 trans-abdominal combined repair), and conservative treatment in 15 patients. CONCLUSIONS: Dynamic magnetic resonance imaging represents a convenient diagnostic procedure in females and to a lesser extent in males, especially in terms of dynamic imaging of pelvic floor organs during defecation. In addition to the clinical assessment, dynamic magnetic resonance imaging had clinical impact in OD and interdisciplinary treatment.
Authors:
Walid Galal Elshazly; Abd El Azez El Nekady; Heba Hassan
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-26
Journal Detail:
Title:  International journal of surgery (London, England)     Volume:  8     ISSN:  1743-9159     ISO Abbreviation:  Int J Surg     Publication Date:  2010  
Date Detail:
Created Date:  2010-05-31     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101228232     Medline TA:  Int J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  274-82     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Colorectal Surgery, Surgical Department, Faculty of Medicine, University of Alexandria, Egypt. wshazly@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Algorithms
Cohort Studies
Constipation / etiology*,  pathology,  physiopathology
Defecography*
Endoscopy, Gastrointestinal
Female
Humans
Intestinal Obstruction / etiology*,  pathology*,  physiopathology
Magnetic Resonance Imaging*
Male
Manometry
Middle Aged
Patient Positioning
Pelvic Floor
Reproducibility of Results
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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