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首页> 外文期刊>International journal of colorectal disease. >A comparison of dynamic transperineal ultrasound (DTP-US) with dynamic evacuation proctography (DEP) in the diagnosis of cul de sac hernia (enterocele) in patients with evacuatory dysfunction.
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A comparison of dynamic transperineal ultrasound (DTP-US) with dynamic evacuation proctography (DEP) in the diagnosis of cul de sac hernia (enterocele) in patients with evacuatory dysfunction.

机译：动态经会阴超声检查（DTP-US）与动态疏散直肠造影术（DEP）在排空功能障碍患者的小腿疝（肠疝）诊断中的比较。

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BACKGROUND/AIMS: Cul-de-sac hernias (enterocele and peritoneocele) are difficult to diagnose in patients presenting with primary evacuatory difficulty. Failure to recognize their presence in patients undergoing surgery may lead to poor functional outcome. Accurate diagnosis requires specialized investigation including dynamic evacuation proctography (DEP) or dynamic magnetic resonance (MR) imaging. Recently, dynamic transperineal ultrasonography (DTP-US) has been used for this purpose. This study compares DEP with DTP-US for the diagnosis of cul-de-sac hernias in those patients presenting with evacuatory dysfunction. MATERIALS AND METHODS: Sixty-two female patients with chronically obstructed defecation underwent blinded clinical, DEP, and DTP-US assessment to define the accuracy of diagnosis of cul-de-sac hernias. RESULTS: Both the DEP and the DTP-US techniques show concordance for the diagnosis of cul-de-sac hernias in an unselected patient cohort. Patients in both groups have the same duration of constipation with a greater likelihood of prior hysterectomy in those with cul-de-sac hernias. The diagnosis was established separately by DEP in 88% and in 82% of the cases by DTP-US. Transperineal sonography is discordant with DEP in 45% of cases once the diagnosis of cul-de-sac hernia is made, over the contents of the hernia and over the degree of transvaginal enterocele descent, where DTP-US tends to upgrade enterocele severity. Both techniques confirm the high incidence of concomitant pelvic floor compartment pathology. CONCLUSIONS: Both methods have accuracy for the diagnosis of cul-de-sac hernias in those patients presenting with evacuatory difficulty. Transperineal sonography tends to more readily diagnose peritoneocele and to upgrade enterocele extent. As an office procedure, it is a valuable adjunct to the clinical examination in the diagnosis of cul-de-sac hernia.
机译：背景/目的：伴有原发性排空困难的患者难以诊断囊尾疝（腹膜内和腹膜膨出）。如果无法识别接受手术治疗的患者，可能会导致功能预后不良。准确的诊断需要专门的研究，包括动态疏散直肠造影（DEP）或动态磁共振（MR）成像。最近，动态经会阴超声检查（DTP-US）已用于此目的。这项研究比较了DEP和DTP-US在排空障碍患者中的​​盲点疝的诊断。材料与方法：对62例慢性阻塞性排便的女性患者进行了盲法临床，DEP和DTP-US评估，以定义盲点疝的诊断准确性。结果：DEP和DTP-US技术均显示出在未选择的患者队列中诊断盲囊疝的一致性。两组患者的便秘持续时间相同，在盲囊疝患者中进行子宫全切术的可能性更高。 DEP分别在88％和82％的病例中通过DTP-US进行了诊断。一旦诊断为死疝，在疝内容物和经阴道小肠膨出的程度上，经会阴超声检查与DEP不一致，其中DTP-US倾向于提高小肠疝的严重程度，这在45％的病例中是不正确的。两种技术都证实了骨盆底腔室病变的高发率。结论：两种方法均能准确诊断出排空困难患者的盲囊疝。经会阴超声检查往往更易于诊断腹膜膨出并提高肠膨大程度。作为一种办公程序，它是诊断小腿疝的临床检查的有价值的辅助手段。

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