Abstract
PURPOSE: There is still considerable debate whether internal intussusception represents a functional disorder. We have reviewed our results in an effort to define its symptomatology and to assess defecography. METHODS: Rectopexy has been performed for internal intussusception in 37 patients. Eighteen had solitary rectal ulcer syndrome (SRUS), and 31 had anterior rectal wall prolapse. Defecography demonstrated anterior wall prolapse in 13, circular prolapse in 21, and no disorders in 3 patients. Pelvic floor function was normal. Follow-up varied from one to nine years. RESULTS: Twenty-six patients became asymptomatic. Anterior wall prolapses could not be palpated anymore. All SRUS lesions healed. Patients with SRUS (P<0.001) or circular prolapse (P<0.001) became significantly more asymptomatic. Results in patients with anterior rectal wall prolapse were significantly worse (P<0.001). CONCLUSIONS: Internal intussusception is a distinct functional rectal disorder. Its symptomatology and findings during physical examination are aspecific. Characteristic defecographic features and presence of SRUS are indications for surgery, provided pelvic floor function during straining is normal.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Johansson C, Ihre T, AhlbÄck SO. Disturbances in the defecation mechanism with special reference to intussusception of the rectum (internal procidentia). Dis Colon Rectum 1985;28:920–4.
Fleshman JW, Kodner IJ, Fry RD. Internal intussusception of the rectum: a changing perspective. Neth J Surg 1989;41:145–8.
McCue JL, Thomson JP. Rectopexy for internal rectal intussusception. Br J Surg 1990;77:632–4.
Sarles JC, Arnaud A, Joly A, Sielezneff I. Internal procidentia of the rectum: therapeutic possibilities. Gastroenterol Clin Biol 1991;15:124–9.
Christiansen J, Zhu B-W, Rasmussen OØ, SØrensen M. Internal rectal intussusception: results of surgical repair. Dis Colon Rectum 1992;35:1026–9.
Ihre T. Intussusception of the rectum and the solitary ulcer syndrome. Ann Med 1990;22:419–23.
Shorvon PJ, McHugh S, Diamant NE, Somers S, Stevenson GW. Defecography in normal volunteers: results and implications. Gut 1989;30:1737–49.
Kuijpers JH, De Morree H. Toward a selection of the most appropriate procedure in the treatment of complete rectal prolapse. Dis Colon Rectum 1988;31:355–7.
Mahieu P, Pringot J, Bodart P. Defecography II: contribution to the diagnosis of defecation disorders. Gastrointest Radiol 1984;9:253–6l.
Stuart M. Proctitis cystica profunda: incidence, etiology and treatment. Dis Colon Rectum 1984;27:153–6.
Ford MJ, Anderson JR, Gilmour HM, Holt S, Sircus W, Heading RC. Clinical spectrum of “solitary ulcer” of the rectum. Gastroenterology 1983;84:1533–40.
Keighley MR, Shouler P. Clinical and manometric features of the solitary rectal ulcer syndrome. Dis Colon Rectum 1984;27:507–12.
Martin JK, Culp CE, Weiland LH. Colitis cystica profunda. Dis Colon Rectum 1984;27:153–6.
Kuijpers JH, Schreve RH, Ten Cate Hoedemakers H. Diagnosis of functional disorders of defecation causing the solitary rectal ulcer syndrome. Dis Colon Rectum 1986;29:126–9.
Kuijpers JH, Baeten C, Schreve RH, Ten Cate Hoedemaker HO, Strijk SP, Bleijenberg G. Solitary rectal ulcer syndrome: result of functional defecation disorders? Dig Surg 1988;5:43–6.
Hoffman MJ, Kodner IJ, Fry RD. Internal intussusception of the rectum: diagnosis and surgical management. Dis Colon Rectum 1984;27:435–41.
Holmström B, Brodén G, Dolk A. Results of the Ripstein operation in the treatment of rectal prolapse and internal rectal procidentia. Dis Colon Rectum 1986;29:845–8.
Nicholls RJ, Simson JN. Anteroposterior rectopexy in the treatment of solitary rectal ulcer syndrome without overt rectal prolapse. Br J Surg 1986;73:222–4.
Kuijpers JH, Bleijenberg G. The spastic pelvic floor syndrome: a cause of constipation. Dis Colon Rectum 1985;28:669–72.
Womack NR, Williams NS, Holmfield Mist JH, Morrison JF. Anorectal function in the solitary rectal ulcer syndrome. Dis Colon Rectum 1987;30:319–23.
Snooks SJ, Nicholls RJ, Henry MM, Swash M. Electrophysiological and manometric assessment of the pelvic floor in the solitary rectal ulcer syndrome. Br J Surg 1985;72:131–3.
Mahieu PH. Barium enema and defecography in the diagnosis and evaluation of the solitary rectal ulcer syndrome. Int J Colorectal Dis 1986;1:85–90.
Bleijenberg G, Kuijpers JH. Treatment of the spastic pelvic floor syndrome with biofeedback. Dis Colon Rectum 1987;30:108–11.
Parks AG, Porter NH, Hardcastle JD. The syndrome of the descending perineum. J R Soc Med 1966;59:477–82.
Orrom WJ, Bartolo DC, Miller R, Mortensen NJ, Roe AM. Rectopexy is an ineffective treatment for obstructed defecation. Dis Colon Rectum 1991;34:41–6.
Allen-Mersh TG, Henry MM, Nicholls RJ. Natural history of anterior mucosal prolapse. Br J Surg 1987;74:679–82.
Author information
Authors and Affiliations
About this article
Cite this article
van Tets, W.F., Kuijpers, J.H.C. Internal rectal intussusception—Fact or fancy?. Dis Colon Rectum 38, 1080–1083 (1995). https://doi.org/10.1007/BF02133982
Issue Date:
DOI: https://doi.org/10.1007/BF02133982