Esposito G, Ascione G, Tamburrini O, Settimi A
Chir Pediatr. 1985;26(5):279-81.
Certain forms of severe constipation, unresponsive to medical treatment and classified as "idiopathic", have been thought to be anatomical anomalies due to anterior-displacement of the anus. The difficulty in defecation varies with the anal anomaly: this may range from passing of feces every 3-4 days to sub-occlusion episodes due to obstruction of the rectum from phecaloma and with sign of malnutrition, anemia and hypotrophy. Anatomically the anomaly is characterized by an anterior positioning of the anus which deviates the terminal part of the rectum in a horizontal plane creating a "cul-de-sac" which arrests normal fecal advancement. Fecal stasis in the rectal ampulla leads to an increase in the distensibility of the rectum with loss of the normal stimulus to defecate and contractile activity. Diagnosis is made by physical examination, barium enema (which reveals the rectal "cul-de-sac" and the distension of the colon) and ano-rectal manometry to rule out Hirschsprung diseases. The authors report their experience with 11 cases of anterior displacement of the anus, presenting a simple surgical treatment and the favorable results.
某些形式的严重便秘，对药物治疗无反应且被归类为“特发性”，一直被认为是由于肛门前移导致的解剖学异常。排便困难因肛门异常而异：从每3至4天排便一次到因粪石阻塞直肠而出现的不完全梗阻发作，并伴有营养不良、贫血和发育不良的迹象。从解剖学上讲，这种异常的特征是肛门向前移位，使直肠末端在水平面上发生偏移，形成一个“盲端”，阻碍正常的粪便推进。直肠壶腹内的粪便淤滞导致直肠扩张性增加，失去正常的排便刺激和收缩活动。通过体格检查、钡剂灌肠（可显示直肠“盲端”和结肠扩张）以及肛门直肠测压来排除先天性巨结肠病进行诊断。作者报告了他们对11例肛门前移病例的经验，介绍了一种简单的手术治疗方法及良好效果。
