Relationship between anal pressure and anodermal blood flow: The vascular pathogenesis of anal fissures

摘要: PURPOSE: The aim of this study was to investigate the relationship between anal pressure and anodermal blood flow. METHODS: We performed Doppler laser flowmetry anoderm combined with anorectal manometry in 178 subjects (87 males 91 females; median age, 55 (range, 17–87) years). This group consisted 31 healthy volunteers, 23 patients fecal incontinence, 17 hemorrhoids, 9 fissure. remaining 98 had other colorectal disorders. In 16 controls we examined flow four quadrants canal. RESULTS: Perfusion at posterior midline significantly lower than three segments canal (posterior midline: 0.74±0.26 V; left lateral side: 1.68 ±0.81 right 1.57±0.52 anterior 1.48±0.69 V,P<0.001). overall group, found a significant correlation maximum resting (r=−0.616,P<0.001). nine chronic fissure, mean 125±26 mmHg, which higher hemorrhoids (82±15 mmHg), (66±19 incontinence (42±14 mmHg,P<0.001), whereas base fissure (0.43±0.10 Vvs.0.57±0.19 Vvs.0.75±0.26vs.1.03±0.34 V). ten also studied influence anesthesia on both During administration anesthesia, dropped from 63±21 mmHg 32±15 (P<0.001), increased 0.79±0.22 V 1.31±0.35 (P<0.001). CONCLUSION: Anodermal is less perfusion commissure strongly related pressure. pressure, Our findings support hypothesis that fissures are ischemic ulcers.