Figure. Endoscopic and sonographic findings of a 59-year-old woman with solitary rectal ulcer syndrome. (A) Sigmoidoscopy shows large ulcer with fold convergence (black arrow) in the lower rectum. (B) Increased thickness of internal anal sphincter is noted at mid level of anal canal. (C) Internal anal sphincter is also more thickened at low level of anal canal. TO THE EDITOR: We read with inter...

The aim of this review was to consolidate the impact of recent advances in investigation technology on the clinical diagnostic workup for faecal incontinence. A literature search was made with emphasis on the recent 15 years. The advent of imaging techniques, particularly endoanal ultrasound has improved the understanding of anal incontinence. Of particular significance was the much higher inci...

In normal physiological studies, using electrical, manometric, or cinematographic methods, it is practically impossible to separate the role of the internal sphincter from that of the other elements of the functional ensemble forming the anal sphincteric system (Aron and Thouvenot, 1962; Lawson and Nixon, 1967; Schnaufer et al., 1967). It is only by studying the pathology of the area that it is...

There is an increasing recognition of the importance of internal anal sphincter (IAS) dysfunction presenting as passive faecal incontinence. This problem may manifest after anal sphincterotomy or following the more minimally invasive operations for haemorrhoids, as well as with advancing age. Because of the poor results of IAS plication and the beneficial outcomes with peri-urethral bulking age...

A 42 year-old male, with no relevant medical history except surgery three years before for chronic anal fissure in another center (without information regarding type of surgery), attended outpatient clinic for several week-history of anal pain. The patient related a sudden anal pain without irradiation and without relationship with defecation that improved with flexion of the lower extremities....

INTRODUCTION Anal fissure are defined as a tear in the skin of the anal canal distal to dentate line. Although still there are controversies about the exact management, lateral sphincterotomy is promising. The aim of this series is to present the outcome of lateral sphincterotomy for internal anal sphincter in term of patient satisfaction and complication. PATIENT AND METHODS A prospective si...

OBJECTIVE To assess smooth muscle enfoldment and internal sphincter construction (SMESC) for improvement of continence after intersphincteric resection (ISR) for rectal cancer. METHODS Twenty-four Bama miniature pigs were randomly divided into a conventional ISR group and experimental SMESC group, with 12 pigs in each group. The proximal sigmoid colon was anastomosed directly to the anus in t...

39 The extracellular signal which triggers activation of rho-associated kinase (RhoA/ROCK), the major 40 molecular determinant of basal internal anal sphincter (IAS) smooth muscle tone in humans, is not 41 known. Using human IAS tissues, the presence of the biosynthetic machineries for Ang II, TXA2 and 42 PGF2α were identified. These end products of the renin-angiotensin system (Ang II) and ara...

An acute fissure when observed by everting the anus *shows longitudinal muscle fibres in the floor of the ulcer. These are fibres of the conjoint longitudinal muscle layer which have passed downwards through the internal anal sphincter to gain attachment to the anal canal and perianal skin. If the lesion persists, the longitudinal fibres ulcerate through to expose the underlying whitish circula...