A novel perspective on constipation secondary to sigmoidocele: a retrospective study,Abdominal Radiology

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A novel perspective on constipation secondary to sigmoidocele: a retrospective study
Abdominal Radiology ( IF 2.3 ) Pub Date : 2023-11-18 , DOI: 10.1007/s00261-023-04104-8
Huixuan Xie ₁ , Kongliang Sun ₂

Affiliation

Purpose

Sigmoidocele, which is a type of obstructed defecation syndrome (ODS), is a peritoneal hernia of the pelvic floor that has been seldom studied individually. This study investigated the anatomic characteristics of sigmoidocele based on imaging features.

Methods

This retrospective cohort population comprised adult patients with ODS who underwent defecography between December 2017 and July 2020. Sigmoidocele was classified based on existing criteria. Novel radiological parameters including the vertical distance descended by the sigmoid colon from rest to maximum straining (RMS) and from the inferior border of the sigmoid colon to the superior border of the rectum at maximum straining (MSR) were measured.

Results

Among 275 patients with sigmoidocele, 251 (91.6%) were female. The mean age was 51.53±12.99 years. We classified 26, 205, and 44 cases as grades I, II, and III, respectively. Patients with more severe sigmoidocele had greater sigmoid colon mobility (RMS: 19.13±8.54 mm, 34.45±14.51 mm, and 48.70±20.05 mm for grades I, II, and III, respectively; p < 0.001) and more pronounced compression of the rectum by the sigmoid colon at maximum straining (MSR: 35.23±8.44 mm, 26.33±13.29 mm, and 15.18±18.00 mm, respectively; p < 0.001). We regrouped the patients based on sigmoid colon alignment. Type L patients had the most severe constipation.

Conclusion

Our study presents a novel sigmoidocele classification. The anatomic appearance and location of the herniated sigmoid colon observed using fluoroscopy during defecation may help improve the clinical awareness of ODS caused by sigmoidocele.

中文翻译：

乙状结肠膨出继发便秘的新视角：一项回顾性研究

目的

乙状结肠膨出是排便梗阻综合征 (ODS) 的一种，是一种盆底腹膜疝，很少进行单独研究。本研究根据影像学特征探讨了乙状结肠膨出的解剖学特征。

方法

该回顾性队列人群包括 2017 年 12 月至 2020 年 7 月期间接受排粪造影的 ODS 成年患者。乙状结肠膨出根据现有标准进行分类。测量了新的放射学参数，包括乙状结肠从静止到最大应变（RMS）下降的垂直距离以及最大应变（MSR）时从乙状结肠下缘到直肠上缘的垂直距离。

结果

275 例乙状结肠膨出患者中，251 例（91.6%）为女性。平均年龄为51.53±12.99岁。我们将26例、205例和44例分别分类为I级、II级和III级。乙状结肠膨出较严重的患者乙状结肠活动度较大（RMS：I、II 和 III 级分别为 19.13±8.54 mm、34.45±14.51 mm 和 48.70±20.05 mm； p < 0.001），并且直肠受压更明显乙状结肠在最大应变时（MSR：分别为 35.23±8.44 mm、26.33±13.29 mm 和 15.18±18.00 mm； p < 0.001）。我们根据乙状结肠排列对患者进行重新分组。 L型患者的便秘最严重。