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Purpose: To report the clinical and defecographic features of posterior rectal wall outpouchings, i.e., posterior rectocele and ischiorectal hernia., Materials and Methods: Sixty-six patients with posterior rectal wall outpouching (61 with posterior rectocele and 5 with ischiorectal hernia) were selected among the patients examined in the last two years for defecation disturbance. All patients underwent physical examination, rectoscopy and videodefecography., Results: Posterior rectal wall outpouchings were detected at physical examination in 28 patients and at rectoscopy in 9 patients. Posterior rectocele, more frequent and bigger in men, was usually demonstrated at videodefecography as an outpouching of the lower portion of posterior rectal wall: this finding was visible only in the dynamic phases in 51 patients while it was seen also at rest in 10 patients. In 52 patients, posterior rectocele was associated with other abnormalities--i.e., anterior rectocele (64%), puborectal muscle syndrome (38%), descending perineum (33%), mucosal prolapse (33%) and intussusception (20%). An ischiorectal hernia, defined as a posterolateral ampullar outpouching deeper than 4 cm and already visible at rest, was identified in 5 patients. Descending perineum and anterior rectocele were the most common associated disorders., Conclusions: We report the clinical and defecographic features of these rectal abnormalities and stress the importance of videodefecography in the real-time study of these morphofunctional disorders.

The prospect of xenogeneic transplantation emphasizes the usefulness of codifying the US patterns of normal pig kidney. Nineteen pigs underwent 35 US studies. Pig kidney is similar to the human one in size and US patterns. However, the average human and pig medullary pyramid indexes (MPI) differ, since the latter is half the former (2.10 vs 4.17). This is a valuable finding, since MPI is a tissular index used in the US evaluation of acute renal allograft rejection. Our results demonstrate that US is a reliable method for the morphological assessment of pig kidney and, therefore in our opinion, it should be used as a major diagnostic tool in the study of xenogeneic renal transplantation.