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Scintigraphic assessment of colonic function during defaecation

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Abstract

The aim of this study was to develop a method by which rectal and colonic activity could be examined during defaecation under physiological conditions, in order to evaluate whether the colon plays a role in defaecation. Subjects presented to the Nuclear Medicine department on the day following ingestion of oral In-111 labelled DTPA, when they developed the normal urge to defaecate. Defaecation took place in a private room while dynamic scintigraphy of the rectum and colon was recorded. Fourteen subjects were studied (8 normal subjects, 4 with constipation, 2 with irritable bowel syndrome). In 13 subjects the left colon was visualized during defaecation and emptying was clearly observed in 12. The right colon was visualised in 11 subjects and emptying was seen in 7. Mean percentage segmental evacuation was right colon 20%, left colon 32% and rectum 66%. Colonic emptying occurs during defaecation, which is not a process of rectal evacuation only. This has implications for the understanding of the pathophysiology of obstructed defaecation.

Résumé

Le but de cette étude était de développer une méthode permettant d'examiner l'activité rectale et colique au cours de la défécation dans des conditions phygiologiques afin de déterminer le rôle que joue le côlon dans la défécation. Les sujets se présentent au département de médicine nucléaire le lendemain de l'ingestion orale de DTPA marqués à l'In-111, lorsqu'ils ressentent le besoin urgent d'exonérer. La défécation est réalisée dans un local privé alors même que l'on enregistre la scintigraphie dynamique du côlon et du rectum. Quatorze patients ont été étudiés (8 sujets normaux, 4 avec constipation et 2 avec un syndrome du côlon irritable). Chez 13 des patients, le côlon gauche a été visualisé durant la défécation et l'évacuation a été clairement observée chez 12 patients. Le côlon droit a été visualisé chez 11 patients et l'évacuation chez 7. L'activité d'évacuation segmentaire moyenne du côlon droit est de 20%, du côlon gauche de 32% et du rectum de 66%. L'évacuation du contenu colique survient au cours de la défécation qui n'est ainsi pas qu'un processus d'évacuation rectale. Cette constatation a des implications quant à la compréhension de la pathophysiologie des dyschézies.

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Lubowski, D.Z., Meagher, A.P., Smart, R.C. et al. Scintigraphic assessment of colonic function during defaecation. Int J Colorect Dis 10, 91–93 (1995). https://doi.org/10.1007/BF00341204

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  • DOI: https://doi.org/10.1007/BF00341204

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