Published by Elsevier Ltd. Clinical management is presented and technical details of the repair are discussed. She had an uneventful post-operative course and good continence after days of follow up. The established risk factors in this case included receptive anal intercourse coupled with alcohol use. We review the pertinent surgical principles that should be observed when repairing these injuries, including anatomically correct repair and appropriate suture choice. There is little evidence to support simultaneous faecal diversion for primary repair of acute perineal lacerations.
Actions[ edit ] Its action is entirely involuntary, and it is in a state of continuous maximal contraction. It helps the Sphincter ani externus to occlude the anal aperture and aids in the expulsion of the feces. Sympathetic fibers from the superior rectal and hypogastric plexuses stimulate and maintain internal anal sphincter contraction. Its contraction is inhibited by parasympathetic fiber stimulation.
Anal Stenosis Anal Stricture What is anal stenosis? When a tubular organ or blood vessel becomes excessively narrow such that it can no longer perform as nature intended, it is a condition referred to by physicians as stenosis. Anal stenosis, also known as an anal stricture, is the narrowing of the anal canal, located just before the anal sphincter. What is the anal sphincter?
An understanding of the anatomy of the internal anal sphincter is helpful in avoiding complications during surgical procedures in the anorectal region. The external anal sphincter was composed of three ellipsoid rings of skeletal muscle subcutaneous, superficial, and deep that encircle the anal canal; in contrast, we found that the internal anal sphincter was composed of flat rings of smooth muscle bundles stacked one on top of the other, like the slats of a Venetian blind. In each anal canal, the average number of ring-like slats observed was The smooth muscle fibers and fascia coalesced at three equidistant points around the anal canal to form three columns that extended distally into the lumen and differed in form from the other anal columns. When viewed from an anterior position, the columns were located anteriorly at the observer's right 5 o'clock position , posteriorly at the right 1 o'clock position , and laterally at the left 9 o'clock position.