肛門括約機構の発達ならびに小児特発性直腸脱に関する臨床的研究 : 直腸肛門内圧面からの検討

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In order to clarify a developmental maturation of anorectal sphincterie mechanism, 96 normal children including 10 newborn-infants and 27 infants younger than one year of age were manometrically studied, using a perfusion system with open-tip catheter. Furthermore, 17 patients with rectal prolapse, of whom 13 (76%) were 2-year-old, were studied to elucidate pathophysiology of rectal prolapse in childhood and following results were obtained. 1) In normal infants and children, anal-canal pressure and square of high pressure zone have rapidly increased during infancy. It increased again from the end of pre-school age after a temporary cease in 2 to 3 years of age. Rectal pressure did not eiffer among various age groups. 2) Length of anal canal has rapidly increased in infancy and attained to level of adult before pre-school age. Frequency of rhythmical waves in anal-canal has gradually increased till pre-school age with the age. 3) Manometric studies were performed before and after therapy for rectal prolapse and it was revealed that there were characteristic findings such as an over-contraction of anal-canal after reflexive relaxation. The anal-canal pressure showed higher pressure after distension of the rectal ampulla than before. Resting pressure in anal-canal and square of high pressure zone were higher than those of normal children. It is concluded from these results that anorectal sphincterie mechanism may attain to maturity before 2 years of age and rectal prolapse in childhood may result from a contractive imbalance between levator muscles and external sphincter as its maldevelopment.
日本小児外科学会の論文
1987-08-20

肛門括約機構の発達ならびに小児特発性直腸脱に関する臨床的研究 : 直腸肛門内圧面からの検討

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