Treatment of Internal Rectal Intussusception in Patients with Chronic Constipation

Abstract

Background: The significance of internal rectal intussusception (rectal invagination) in chronic constipation dominated by symptoms of obstructed defecation is not fully clarified. Methods: Seventeen consecutive patients with chronic constipation and a history of obstructed defecation with internal rectal intussusception demonstrated by defecography were treated by perineal rectopexy. Results: Of 15 patients followed up for more than 2 years defecography showed total disappearance of the intussusception in 12. Five of these claimed substantial improvement (42%; 17-72%). Three of four patients with concomitant anal incontinence became fully or partly continent after the rectopexy. Conclusion: In some patients with chronic constipation, dominated by symptoms of obstructed defecation, rectal invagination may be an aggravating factor. The study indicates that rectal invagination does not seem to be the cause but rather a consequence of the obstructed defecation. In selected patients, including those with concomitant faecal incontinence, surgical treatment of the intussusception by a minor procedure may be indicated.

Key Words:

• Anal incontinence
• constipation
• obstructed defecation
• rectopexy