OTHER LARGE INTESTINE
PROCEDURE
Defecogram
 Relatively
new radiologic
procedure performed for the
patient with a defecation
dysfunction.
 Purpose:
 Functional study of the anus
and rectum during the
evacuation and rest phases of
defecation.
Clinical Indications
 Rectoceles
 Rectal
Intussusception
 Prolapse of the
rectum
Rectoceles
 Common form of
pathology.
 A blind pouch of the
rectum due to weakening
of the anterior or posterior
wall.
Rectoceles
Rectal Intussusception
 Rectal Intussusception is a
term that denotes that lower
part of the bowel [the lower
sigmoid or upper rectum]
slides inside the rectum so
that there will be a tube
inside a tube,
Rectal Intussusception
Prolapse of the rectum
 Rectal prolapse normally
describes
a
medical
condition
wherein
the
walls
of
the
rectum
protrude through the anus
and hence become visible
outside the body
Prolapsed of the rectum
Contrast Media:
 To study the process of
evacuation, a very high density
barium sulfate mixture is
required.
 Other investigator mixed diluted
suspension of barium sulfate,
heated it, and added potato
starch to form a smooth barium
paste that was semisolid and
malleable.
Colostomy Studies
 Enterostomy
 general term applied to the
surgical
procedure
of
forming an artificial opening
to the intestine, usually
through the abdominal wall,
and to the resultant fecal
passage.
COLOSTOMY
Colostomy
 A colostomy is a surgical procedure
that involves connecting a part of
the
colon
onto
the
anterior
abdominal wall, leaving the patient
with an opening on the abdomen
called a stoma.
 In a colostomy, the stoma is formed
from the end of the large intestine,
which is drawn out through the
incision and sutured to the skin.
Types of Colostomy
 Loop Colostomy:
 This type of colostomy is usually used
in emergencies and are temporary and
large Stoma.
 A loop of the bowel is pulled out onto
the abdomen and held in place with an
external device.
 The bowel is then sutured to the
abdomen and two openings are created
in the one stoma: one for stool and the
other for mucus.
End Colostomy:
 A stoma is created from
one end of the bowel.
The other portion of the
bowel is either removed
or sewn shut
(Hartmann's pouch).
Double Barrel Colostomy:
 The bowel is severed and both
ends are brought out onto the
abdomen. Only the proximal
stoma is functioning.
 Colostomy surgery that can be
planned ahead often has a
higher rate of long-term success
than those done in emergency
surgery.
Indications:
Diverticulitis
Ulcerative colitis
Diverticulitis
 Develops from
diverticulosis, which
involves the formation of
pouches (diverticula) on
the outside of the colon.
Ulcerative colitis
 Ulcerative colitis is a disease that
causes inflammation and sores, called
ulcers, in the lining of the rectum and
colon.
 Ulcers form where inflammation has
killed the cells that usually line the
colon, then bleed and produce pus.
 Inflammation in the colon also causes
the colon to empty frequently, causing
diarrhea.
Ulcerative colitis
Colostomy enema equipment
 Enema can or bag
 Catheters
 Tips
 Adhesive disk
Colonogram procedures
 Distal colonogram
 a procedure in which water-soluble
contrast is instilled into a
dysfunctional colon via a stoma.
 A small balloon catheter is inserted
into the distal stoma, the balloon
inflated, and contrast injected by hand
to adequately distend the dysfunction
loop and in the case of anorectal
atresia to demonstrate any fistula.
Common Indications
 Hirschsprung's
disease,
or
congenital
aganglionic
megacolon,
involves
an
enlargement of the colon, caused
by bowel obstruction resulting
from an aganglionic section of
bowel (the normal enteric nerves
are absent) that starts at the anus
and progresses upwards.
Procedure
 2 types of entry
 Proximal colonogram
 Distal colonogram