直肠内脱垂合并盆底疝的影像学诊断  

Imaging diagnosis of internal rectal prolapse complicated with pelvic floor hernia

作　　者：王毅[1] 龚水根[1] 张伟国[1] 张胜本[2] 张连阳[2] 

机构地区：[1]第三军医大学大坪医院野战外科研究所影像诊断科,重庆400042 [2]第三军医大学大坪医院野战外科研究所普通外科,重庆400042

出　　处：《中华胃肠外科杂志》2004年第4期273-275,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的评价盆腔造影结合排粪造影对直肠内脱垂合并盆底疝的诊断价值。方法回顾性分析120例直肠内脱垂合并盆底疝患者的影像学表现,观察直肠型盆底疝和不含直肠型盆底疝的其他类型疝合并直肠内脱垂的类型。结果盆腔造影结合排粪造影片上,120例盆底疝有直肠型56例、间隔型27例、阴道型12例和混合型25例,而混合型中有18例直肠型盆底疝。分组结果显示,74例直肠型盆底疝均合并全层直肠套叠,盆底疝疝囊位于套叠的直肠壁环形浆膜囊袋内;46例不含直肠型盆底疝的其他类型疝均不合并全层直肠套叠。结论盆腔造影结合排粪造影能准确诊断各型盆底疝,由于直肠型盆底疝与全层直肠套叠合并出现,因此,盆腔造影结合排粪造影也能准确区分全层直肠套叠与直肠黏膜脱垂。Objective To evaluate the value of pelviography combined with defecography in the diagnosis of internal rectal prolapse (IRP) complicated with pelvic floor hernia. Methods One hundred and twenty patients with IRP complicated with pelvic floor hernia underwent pelviography combined with defecography. The imaging manifestations of IRP and pelvic floor hernias were analyzed retrospectively. Results The pelvic floor hernias in these cases could be divided into rectal type in 56 cases, septal type in 27, vaginal type in 12 and mixed type in 25 cases on the pelviography combined with defecography films. Among the 25 cases of mixed type, 18 cases also had rectal pelvic floor hernia. All the 74 patients with rectal pelvic floor hernia had full thickness rectal intussusception (FTRI), the rectal pelvic floor hernia was in the serosal ring-pocket of the intussuscepted rectum. Forty-six patients without rectal pelvic floor hernia had no FTRI, but rectal mucosal prolapse (RMP). Conclusions Pelviography combined with defecography can accurately diagnose various pelvic floor hernias. FTRI is complicated with rectal pelvic floor hernia. Therefore, pelviography combined with defecography may offer discrimination diagnosis of FTRI from RMP.

关 键 词：直肠内脱垂 合并症 盆底疝 影像学诊断 盆腔造影 排粪造影 

分 类 号：R657.1[医药卫生—外科学]