Author/Editor		Kolodziejczak, Malgorzata; Sudol-Szopinska, Iwona; Grochowicz, Maciej; Bochenek, Anna; Swiatlowska, Magdalena
Title		The estimation of the value and mobility of Parks' angle in case-series of patients with defectory disorders - prospective clinical examination supplemented with the defecographic examination
Translated title		Ocena Parksovega kota pri bolnikih z motnjami odvajanja blata - prospektivna raziskava z defekografijo
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 40, št. 1
Publication year		2006
Volume		str. 7-15
Language		eng
Abstract		Background. Defecography is used by a majority of colorectal surgeons for it is the only method for anatomic and dynamic studies of the act of defecation. The method provides information on different aspects of anorectal and pelvic floor function and offers the possibility of visualizing the development of anatomic abnormalities. Methods. We analyzed the defecography findings carried out at 56 patients (50 female and 6 male) from 24 to 83 years of age (the average age 58.3 years) with proctologic ailments such as: faecal incontinence, sensation of obstruction in the rectum, constipations, rectal prolapse, solitary ulceration of rectum. The values of Parks' angle (ARA - the anorectal angle) were measured at rest, at strain and during defecation. Other parameters measured included: duration of sphincter relaxation, overall duration of defecation, mobility of the pelvic diaphragm. Results. Abnormal values of Parks' angle at rest and at strain were found in patients with the following problems: faecal incontinence, sensation of obstruction in rectum and constipation. However, they did not turn out to be characteristic for patients with rectal prolapse. Defecography has helped to detect concomitant rectocele in patients suffering from constipation and sensation of obstruction in the rectum. Defecography has also proved to be effective in the evaluation of patients who suffered from solitary ulceration of rectum. During the examination of these pah'ents it has been observed that Parks' angle in various phases of defecation has flattened. The duration of sphincter relaxation in the studied group was changeable and did not depend on the kind of pathology. Conclusions. Defecography is one of the examinations which can be helpful in the evaluation of patient's motor functions both before and after the operation.
Summary		Izhodišča. Defekografijo uporablja veliko kolorektalnih kirurgov, ker lahko z njo anatomsko in dinamično proučujejo odvajanje blata. S preiskavo ugotovimo anorektalno funkcijo in delovanje medeničnega dna ter anatomske nepravilnosti. Metode. V prospektivni raziskavi smo z defekografijo proučili 58 bolnikov (50 žensk in 6 moških), ki so bili stari od 24 do 83 let (povprečno 58,3 leta) in so imeli proktološke težave. Bolniki so opisovali nezmožnost zadrževati blato, občutek obstrukcije v rektumu, zaprtost, zdrs rektuma in rektalno razjedo. Velikost Parksovega kota smo merili pred odvajanjem blata, med napenjanjem in med odvajanjem blata. Merili smo tudi trajanje sfinkterske relaksacije, trajanje odvajanja blata in gibljivost medenične prepone. Rezultati. Nenormalne vrednosti Parksovega kota smo ugotavljali pred odvajanjem blata in med napenjanjem pri bolnikih, ki niso uspeli zadrževati blato, ki so imeli občutek obstrukcije v rektumu ali so bili zaprti. Pri zdrsu rektuma pa omenjene nenormalne vrednosti nismo zasledili. Defekografija nam je pomagala odkriti rektokelo pri bolnikih, ki so tožili zaradi zaprtosti in občutka obstrukcije v rektumu. Koristna je bila tudi pri oceni bolnikov, ki so imeli rektalno razjedo. Parksov kot se je med odvajanja blata spreminjal, trajanje sfinkterske relaksacije pa je bilo spremenljivo ne glede na vrsto bolezni. Zaključki. Defekografija je koristna metoda pri motorični oceni odvajanja blata pred in po kirurškem zdravljenju.
Descriptors		CONSTIPATION FECAL INCONTINENCE RECTUM CONTRAST MEDIA VIDEOTAPE RECORDING RECTAL PROLAPSE ULCER