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PTH-016 Defecating Scintigraphic Photography at St George’S Hospital: Review of Findings and Correlation with Patient Symptoms
  1. R I Rusu1,
  2. N Beharry2,
  3. A Irwin3,
  4. S Heenan4,
  5. A Poullis1
  1. 1Gastroenterology Department, St George’s Hospital
  2. 2Radiology, St. George’s Hospital
  3. 3Medical Physics
  4. 4Radiology, St George’s Hospital, London, UK


Introduction Defecating scintigraphic proctograms (DSPs) have an established position in the investigation of evacuatory problems and ano-rectal symptoms. Functional radionuclide imaging allows for both the assessment of rectoceles and correlation with evacuatory function.

Methods 151 consecutive DSPs carried out over a 3-year period were reviewed. Clinical details of presenting symptoms were reviewed with the study results. All studies were reviewed for evidence of anatomical abnormalities and function via % excretion. The % excretion was analysed in those with and without a rectocele and compared with symptoms (constipation, incontinence, rectal pain and evacuatory difficulty). The mean % excretion for each symptom (present/absent) was calculated and compared with a t test.

Results Of the 151 patients, 23 were unable to defecate and no results were available. There were 8 males, 143 females. Mean age range 55 +/- 14. 76% had a rectocele demonstrated. In all patients % excretion was significantly different in those with symptomatic evacuatory difficulty (% excretion: Constipation present/absent 63% v 62.6% p = 0.9, Incontinence present/absent 60.9% v 63.4% p = 0.46, Pain present/absent 67.2% v 62.1%, p = 0.24, Evacuatory difficulty present/absent 60.2% v 66.3% p = 0.03). Of those with a rectocele there was a non-significant trend to abnormality on excretory function (% excretion: Constipation present/absent 62.8% v 61.8% p = 0.8, Incontinence present/absent 60.9% v 62.6% p = 0.6, Pain present/absent 66.6% v 61.5%, p = 0.33, Evacuatory difficulty present/absent 59.7% v 65.9% p = 0.06). On those without a rectocele, there was no difference in excretory function in any symptom groups.

Conclusion In this large series DSPs identified rectoceles in 76% of studies. In those with a rectocele functional impairment was often present, with a trend to reduced % excretion seen. In those without a rectocele % excretion on DSPs did not differ in any symptom group. Larger reviews are needed to identify small sub-groups who may benefit from this study. The significant number with abnormalities found on DSPs suggests that this investigation may be underutilised in those with ano-rectal symptoms.

Disclosure of Interest None Declared.

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