An experimental study on the mechanism of rectosphincteric reflex in special reference to Hirschsprung's disease

A comparison of simultaneous longitudinal and radial recordings of anal canal pressures

A new anal manometry perfusion catheter is described that offers the capability of simultaneous linear longitudinal pressure measurements. The authors studied 20 control subjects with this catheter and with a four-quadrant perfusion catheter. An asymmetry of basal, squeeze, and relaxation pressures was found. The highest basal pressures were in the middle of the anal canal, regardless of quadrant orientation. Using the radial perfusion catheter, the squeeze pressure profile was consistent with a double-loop external sphincter mechanism. Using the linear perfusion catheter, the internal sphincter relaxation pressures show a greater negative deflection at the proximal portions of the sphincter, which was not achieved at points distally in the same quadrant. This implies that during reflex relaxation, pressure is maintained in the distal anal canal so that patients remain continent during sensory sampling of rectal contents. The authors believe this is the first time this same-quadrant longitudinal asymmetry of relaxation has been shown with a single rectal balloon stimulus.

New approach to surgical treatment of ulcerative colitis and polyposis coli without pelvic pouch. Experimental study in dogs

A new method for the surgical treatment of ulcerative colitis and polyposis coli is described. Instead of preparing a pelvic pouch, the natural rectal pouch stripped of the diseased mucosa was used experimentally in dogs. The undisturbed muscular cuff of the rectum (12 cm from the anal verge) was covered by healthy vascularized mucosa of small bowel in such a manner that the dog could use its rectum as usual before surgery. The results are encouraging. The rectal reservoir is spared, with its sensitivity, continence and motor activity covered by healthy mucosa. The dogs thrived.