Iwai J, Takahashi H, Maie M, Ohnuma N, Etoh T, Tanabe M, Aoyagi H, Shinbo K
Department of Pediatric Surgery, Chiba University School of Medicine.
Nihon Heikatsukin Gakkai Zasshi. 1988 Jun;24(3):193-203. doi: 10.1540/jsmr1965.24.193.
APA is a common cause of constipation, and is the mild case of the imperforated anus. On diagnosing APA, anterior displacement of the anus and normal distribution of the external anal sphincter to the anus are essential. To determine the location of the anus in the perineum simple clinical technique was developed. In 61 normal cases, the result of measurement was almost same in each sex, but in 3 APA cases the location were anteriorly dislocated than normal cases. Distribution of the external anal sphincter was evaluated with electromyographic technique, and location map of the sphincter was made. In 3 APA cases, the anus was totally surrounded by the external anal sphincter, but in 17 ano-cutaneous fistula cases, the opening was anteriorly dislocated to the sphincter distribution map. As a conclusion, newly proposed simple clinical technique to determine anal location and electromyographic examination of the external and sphincter distribution are very useful in objective diagnosis of APA.
肛门前移（APA）是便秘的常见原因，也是肛门闭锁的轻症病例。诊断APA时，肛门的前移位以及肛门外括约肌向肛门的正常分布至关重要。为了确定肛门在会阴中的位置，开发了一种简单的临床技术。在61例正常病例中，各性别测量结果几乎相同，但在3例APA病例中，其位置比正常病例向前移位。采用肌电图技术评估肛门外括约肌的分布，并绘制了括约肌的位置图。在3例APA病例中，肛门完全被肛门外括约肌包围，但在17例肛门皮肤瘘病例中，开口在括约肌分布图上向前移位。结论是，新提出的用于确定肛门位置的简单临床技术以及对肛门外括约肌分布的肌电图检查，在APA的客观诊断中非常有用。
