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폐쇄성 배변장애 환자의 생리적 및 임상적 특징

The Clinical and Physiologic Characteristics of Patients with Pelvic Outlet Obstructive Disease

대한대장항문학회지 2005년 21권 6호 p.362 ~ 369
안은정 ( Ahn Eun-Jung ) - 이화여자대학교 의과대학 외과학교실

정규영 ( Jung Gyu-Young ) - 이화여자대학교 의과대학 외과학교실
천승희 ( Cheon Seung-Hui ) - 이화여자대학교 의과대학 외과학교실
이은정 ( Lee Eun-Joung ) - 이화여자대학교 의과대학 외과학교실
오수연 ( Oh Soo-Yoon ) - 건국대학교 의과대학 외과학교실
정순섭 ( Chung Soon-Sup ) - 이화여자대학교 의과대학 외과학교실
이령아 ( Lee Ryung-Ah ) - 이화여자대학교 의과대학 외과학교실
김광호 ( Kim Kwang-Ho ) - 이화여자대학교 의과대학 외과학교실
박응범 ( Park Eung-Bum ) - 이화여자대학교 의과대학 외과학교실

Abstract


Purpose: With recent anorectal physiologic studies, functional etiologies of pelvic outlet obstructive disease were evaluated in detail. The current study was designed to assess the clinical and the physiologic characteristics of patients with pelvic outlet obstructive disease.

Methods: one hundred two (102) patients with pelvic outlet obstructive disease were evaluated with anorectal physiologic studies, including the colonic transit time (n=66), anorectal manometry (n=88), defecography (n=102), anal sphincter EMG (n=50), and colonoscopy or barium enema (n=77). The patients were categorized as group I (nonrelaxing puborectalis syndrome), group II (rectocele), group III (sigmoidocele), and group IV (rectoanal intussusception). The clinical and the physiologic characteristics were compared between the groups.

Results: The mean age was 51.9 years, and the sex ratio was 1:1.9. the populations of the groups were group I 45.1% (n=46), group II 36.3% (n=37), group III 5.9% (n=6), and group IV 9.8% (n=10). In group II and group III, co-existing etiologies were more, and the incidences of female patients was higher (P<0.05). Delayed colonic transit time was noted in 11 patients (17%). Diverticula was observed in 6 patients (8%), polyps in 12 patients (16%), and melanosis coli in 14 patients (18%). On anorectal manometry, group I showed higher maximal voluntary contraction and mean squeezing pressure than the other groups (P<0.05). On defecography, group I had a shorter perineal descent at rest and a smaller anorectal angle at push (P<0.05).

Conclusions: The current study showed the clinical and the physiologic characteristics of the each functional etiology in patients with pelvic outlet obstructive disease. These results provide fundamental data for diagnosis of and tailored therapy for pelvic outlet obstructive disease. J Korean Soc Coloproctol 2005;21:362-369

키워드

폐쇄성 배변장애;치골직장근 이완부전증;직장류;에스결장류;직장항문 중첩증
Pelvic outlet obstructive disease;Nonrelaxing puborectalis syndrome;Rectocele;Sigmoidocele;Rectoanal intussusception
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