小児慢性便秘症(Idiopathic Megacolon)における注腸造影と直腸肛門内圧測定の検討および治療法

概要

論文の詳細を見る
In 18 infants with severe constipation presenting with abdominal distension, staining of underpants, and overflow incontinence, radiologic, manometric, and histochetnical studies of the rectum were performed. Radiologic study: By barium enema examination, rectal dilatation ratio (Rectal transverse diameter divided by pelvic transverse diameter on frontal X-ray view) was investigated. It was greater than 60% in all cases. The PC-R angle (angle of rectal floor line against P-C line on lateral X-ray view described in figure) was found to range from +20°to -20°. Manometric study: Anorecta reflex was present in all cases. Rectal pressure was 10.8±4.3cm H_2O, and anal resting pressure 25.3±7.1cmH_2O. This pressure study did not show statistical difference from that of normal infants. The rectal dilatation ratio was related to the PC-R angle. The anal resting pressure seemed to be related to the rectal dilatation ratio. Patients with an anal resting pressure above 30cmH_2O and a dilatation ratio greater than 90% have high incidence of severe constipation. All cases were treated conservatively suppository, clyster and catharics, and improved to good condition within 6 months. One case was treated for 3 years without improvement and operative internal-sphincterectomy is planned in the near future.
1983-06-20