Functional Disorders: Rectoanal Intussusception

Eric G. Weiss; Elisabeth C. McLemore

doi:10.1055/s-2008-1075861

Clinics in Colon and Rectal Surgery, Table of Contents

Clin Colon Rectal Surg 2008; 21(2): 122-128
DOI: 10.1055/s-2008-1075861

Functional Disorders: Rectoanal Intussusception

Eric G. Weiss¹ , Elisabeth C. McLemore¹

¹Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida

Abstract

ABSTRACT

Rectoanal intussusception (RI) is a telescoping of the rectal wall during defecation. RI is an easily recognizable physiologic phenomenon on defecography. The management, however, is much more controversial. Two predominant hypotheses exist regarding the etiology of RI: RI as a primary disorder, and RI as a secondary phenomenon. The diagnosis may be suspected based on clinical symptoms of obstructive defecation. Diagnostic modalities include defecography as the gold standard. Dynamic pelvic magnetic resonance imaging (DPMRI) and transperineal ultrasound are attractive alternatives to defecography; however, their sensitivity is poor in comparison to the gold standard at this time. Management strategies including conservative measures such as biofeedback and surgical procedures including mucosal proctectomy (Delorme), rectopexy, and stapled transanal rectal resection (STARR) procedures have varied degrees of efficacy.

KEYWORDS

Rectoanal intussusception - defecography - biofeedback - Delorme - rectopexy - stapled transanal rectal resection (STARR)

Full Text

References

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Eric G WeissM.D.

Department of Colorectal Surgery, Cleveland Clinic Florida

2950 Cleveland Clinic Blvd., Weston, FL 33331

Email: weisse@ccf.org