Abstract：
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.
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.
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.
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.
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.
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.
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.
摘要：
目标：乙状结肠膨出，这是一种阻塞排便综合征（ODS），是骨盆底的腹膜疝，很少单独研究。本研究基于影像学特征探讨了乙状结肠膨出的解剖学特征。
方法：本回顾性队列人群包括2017年12月至2020年7月接受排粪造影的ODS成年患者。根据现有标准对乙状结肠膨出进行分类。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）以及从乙状结肠下边界到最大应变（MSR）时直肠上边界的垂直距离。
结果：在275例乙状结肠膨出患者中，251人（91.6%）为女性。平均年龄为51.53±12.99岁。我们将26、205和44例分为一级，II,III,分别。严重的乙状结肠膨出患者的乙状结肠活动度更大（RMS：19.13±8.54mm，34.45±14.51mm,等级I为48.70±20.05mm，II,III,分别；p<0.001）和最大应变时乙状结肠对直肠的压缩更明显（MSR：35.23±8.44mm，26.33±13.29mm,和15.18±18.00毫米，分别为；p<0.001)。我们根据乙状结肠排列对患者进行了重新分组。L型患者便秘最严重。
结论：我们的研究提出了一种新的乙状结肠膨出分类。排便期间使用透视观察乙状结肠疝的解剖外观和位置可能有助于提高临床对乙状结肠膨出引起的ODS的认识。
方法：本回顾性队列人群包括2017年12月至2020年7月接受排粪造影的ODS成年患者。根据现有标准对乙状结肠膨出进行分类。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）以及从乙状结肠下边界到最大应变（MSR）时直肠上边界的垂直距离。
结果：在275例乙状结肠膨出患者中，251人（91.6%）为女性。平均年龄为51.53±12.99岁。我们将26、205和44例分为一级，II,III,分别。严重的乙状结肠膨出患者的乙状结肠活动度更大（RMS：19.13±8.54mm，34.45±14.51mm,等级I为48.70±20.05mm，II,III,分别；p<0.001）和最大应变时乙状结肠对直肠的压缩更明显（MSR：35.23±8.44mm，26.33±13.29mm,和15.18±18.00毫米，分别为；p<0.001)。我们根据乙状结肠排列对患者进行了重新分组。L型患者便秘最严重。
结论：我们的研究提出了一种新的乙状结肠膨出分类。排便期间使用透视观察乙状结肠疝的解剖外观和位置可能有助于提高临床对乙状结肠膨出引起的ODS的认识。
