Novosti
Khirurgii

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Year 2013 Vol. 21 No 4

NEW METHODS

M.D. LEVIN 1, J.G. DEGTYAROV 2, V.I. AVERIN 2, I.F. ABU-VARDA 3 , T.M.BOLBAS 4

STANDARDIZATION OF RADIOLOGICAL EXAMINATION OF THE COLON AND ANORECTAL AREA

Geriatric center, NETANYA, ISRAEL,
EE “Belarusian State Medical University” 2,
SBE “Belarusian Medical Academy of Postgraduate Education” 3,
ME "The 1st Municipal Clinical Hospital", Minsk 4, The Republic of Belarus

Objectives. To modify the irrigoscopy method and using it to determine the normal parameters of the colon and rectum as well as the anal cannel in different age groups. To determine the changes of these parameters at anorectal anomalies and chronic constipations.
Methods. The proposed method was performed in 501 patients, including 65 children without abnormalities of the colon and rectum, but with abdominal pain or volume formation in the abdominal cavity. A chronic constipation is considered to be a reason for the examination in 436 patients (356 children and 80 patients older than 65 years). Modification of irrigoscopy differs from the usual barium enema by placing of radiopaque marker near the anus; it permitted to measure the length of the anal canal. Contrast medium was introduced prior to the reflux start into the ileum; it allowed measuring the colon volume.
Results. The maximal widths of the rectum and various segments of the colon, length of the anal canal and volume of the colon have been measured in 65 children of different age without any pathology of the anorectal zone. The obtained parameters have been taken as an age-specific norm. The shortening of the roentgen-negative distance between the rectum and the marker near the anus was found in the patients with abnormal puborectal function.
Conclusions. Standardization of irrigoscopy has allowed to calculate the normal parameters of the rectum, all segments of the colon and the volume of the colon in different age groups. Up to present the obtained data are considered to be the exclusive criteria in the world literature. The use of radiopaque marker near the anus permits to determine the length of the anal canal in norm and to assess the puborectal function in various pathological states. The proposed method can dramatically increase the accuracy of the diagnosis without increasing the radiation dose in comparison with conventional irrigoscopy. This technique is equally applicable in both children and adult patients.

Keywords: irrigoscopy, rectal width, puborectalis, constipation, anorectal anomalies
p. 90 – 98 of the original issue
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Address for correspondence:
Amnon ve-Tanar, 1/2, 42202, Netanya, Israel Geriatricheskii tsentr,
e-mail: nivel70@hotmail.com,
Levin Mikhail Davydovich
Information about the authors:
Levin M.D. MD, a radiologist of the state geriatric center, Netanya, Israel.
Degtyarov J.G. PhD, an associate professor of the pediatric surgery chair of SEE “Belarusian Medical Academy of Postgraduate Education”.
Averin V.I. MD, professor, a head of the pediatric surgery chair of SEE “Belarusian Medical Academy of Postgraduate Education”.
Abu-Varda I.F. PhD, an associate professor of the pediatric surgery chair of SEE “Belarusian Medical Academy of Postgraduate Education”.
Bolbas T.M. A radiologist of ME “The 1st city clinical hospital”, Minsk.
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