ABC of colorectal diseases. Haemorrhoids.
نویسنده
چکیده
Large haemorrhoids. The dentate line, which should be halfway up the anal canal, can be clearly seen separating the prolapsed anal cushions (autonomic innervation) from the secondarily congested external plexus (somatic innervation). Haemorrhoids and related conditions are not popular with patients or doctors and are commonly relegated for treatment to a junior member of the surgical team. This is a pity because .they are so common and may cause considerable distress, and with expert assessment many can be cured by outpatient measures. Haemorrhoids (or piles) are displaced anal cushions. The cushions are normal structures that have a rich arterial supply leading directly into distensible venous spaces. They help seal the upper anal canal and contribute to continence. Constipation and straining disrupt the supporting framework of the cushions, causing them to become displaced and congested. In some patients this is aggravated by a tight internal sphincter, which leads to high intra-anal pressure during a bowel action.
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عنوان ژورنال:
- BMJ
دوره 304 6833 شماره
صفحات -
تاریخ انتشار 1992