| Popis: |
Rectosphincteric manometric studies in patients with anal fissures demonstrated an abnormal internal anal sphincter reflex in response to rectal distention. This abnormal reflex response, characterized by an overshoot contraction immediately after a normal relaxation, was present in all 7 patients with fissures, but not in 17 subjects without anal disease. In 3 patients studied after treatment, the response returned to normal. These studies suggest that reflexly stimulated internal sphincter spasm plays a role in the pathogenesis of anal fissures, and that surgical approaches should be directed to the internal, rather than the external anal sphincter. |
