• Title/Summary/Keyword: Anorectal angle

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Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.5-12
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    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

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The Latest Trend of Dynamic MR Defecography for the Chronic Constipation Patient (만성 기능성 변비 환자에서 동적 MR Defecography의 최신동향)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
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    • v.27 no.4
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    • pp.17-21
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    • 2004
  • With advancement of the medical imaging technology, the dynamic pelvic MRI (magnetic resonance imaging) has been introduced and used for dynamic MR defecography to improved diagnosis of the patients. At the early stage of its use, it was mostly used to diagnose enterocele or cystocele, then its use was extended to diagnose the organ prolapse and other dysfunctional pelvis organs. There now have been many reports of other diseases such as the functional constipation and others. This paper introduces the pelvis MRI and the dynamic MR defecography and reports the future trend in their clinical applications. Until recently, the studies with pelvic MRI were mostly focused on observing the movement of the pelvis in the supine position. Yang and 26 others reported good result in observing the patients with the pelvic organ prolapse by using the pubococcygeal line as the anatomical index. Using the fast gradient recalled acquisition (fast GRASS), they compared cystocoele, genitourinary prolapse, enterocoele and rectocoele with the control group. Kruyt et al. observed the posterior compartment and reported that MRI was more helpful than the fluoroscopy. Healy et al. applied the dynamic MRI test on the patients with constipation or incontinence as well as the control group without those symptoms. Since then, MRI technology has further advance by Lienemann, who was able to attain the more detailed images using the fast T2 weighted turbo spin echo technology, and others. If its limitation in diagnosing intussusception and the like, since the observation can be made only from the supine position, can be overcome with open MR or others, it is envisages that the method can eventually replace the radiological defecography.

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