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MR of Obstructed Defecation
Rania Farouk El Sayed, MD, PhD
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KEY FACTS

  • Terminology

    • MR Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Obstructed defecation (OBD)
            • Synonyms

              • Outlet obstruction, OBD syndrome
            • Definitions

              • OBD
                • Disorder resulting in difficulty evacuating stool from rectum
                • Characterized by frequent visits to toilet, sensation of incomplete emptying of bowels, often with straining to defecate
              • Constipation
                • Describes symptom, not clinical sign, particularly subjective, which means different things to different people, such as bowel frequency, ease of defecation, stool size/consistency
              • Infrequent defecation
                • Usually defined as < 3 bowel movements per week
                  • Frequently associated with slow-transit time; slow-transit constipation (STC)
              • Difficult evacuation
                • Straining at stool is considered abnormal if it occurs for > 25% of time spent in lavatory

            MR Imaging

            • Technical Considerations

              • Abnormal Findings on Static MR Imaging

                • MR Defecography

                  • Dynamic Cine MR During Maximum Straining

                    • Correlation Between Dynamic & Static MR

                      Pathology

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            Clinical Issues

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    Diagnostic Checklist

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Lalwani N et al: Imaging and clinical assessment of functional defecatory disorders with emphasis on defecography. Abdom Radiol (NY). 46(4):1323-33, 2021
                                        2. El Sayed RF: Integrated MR analytical approach and reporting of pelvic floor dysfunction: current implications and new horizons. Radiol Clin North Am. 58(2):305-27, 2020
                                        3. Sanchez MI et al: Epidemiology and burden of chronic constipation. Can J Gastroenterol. 25 Suppl B:11B-5B, 2011
                                        4. Belsey J et al: Systematic review: impact of constipation on quality of life in adults and children. Aliment Pharmacol Ther. 31(9):938-49, 2010
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • MR Imaging

                                            • Pathology

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Obstructed defecation (OBD)
                                                  • Synonyms

                                                    • Outlet obstruction, OBD syndrome
                                                  • Definitions

                                                    • OBD
                                                      • Disorder resulting in difficulty evacuating stool from rectum
                                                      • Characterized by frequent visits to toilet, sensation of incomplete emptying of bowels, often with straining to defecate
                                                    • Constipation
                                                      • Describes symptom, not clinical sign, particularly subjective, which means different things to different people, such as bowel frequency, ease of defecation, stool size/consistency
                                                    • Infrequent defecation
                                                      • Usually defined as < 3 bowel movements per week
                                                        • Frequently associated with slow-transit time; slow-transit constipation (STC)
                                                    • Difficult evacuation
                                                      • Straining at stool is considered abnormal if it occurs for > 25% of time spent in lavatory

                                                  MR Imaging

                                                  • Technical Considerations

                                                    • Abnormal Findings on Static MR Imaging

                                                      • MR Defecography

                                                        • Dynamic Cine MR During Maximum Straining

                                                          • Correlation Between Dynamic & Static MR

                                                            Pathology

                                                            • General Features

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  Clinical Issues

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          Diagnostic Checklist

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Lalwani N et al: Imaging and clinical assessment of functional defecatory disorders with emphasis on defecography. Abdom Radiol (NY). 46(4):1323-33, 2021
                                                                              2. El Sayed RF: Integrated MR analytical approach and reporting of pelvic floor dysfunction: current implications and new horizons. Radiol Clin North Am. 58(2):305-27, 2020
                                                                              3. Sanchez MI et al: Epidemiology and burden of chronic constipation. Can J Gastroenterol. 25 Suppl B:11B-5B, 2011
                                                                              4. Belsey J et al: Systematic review: impact of constipation on quality of life in adults and children. Aliment Pharmacol Ther. 31(9):938-49, 2010