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International Journal of Colorectal Disease

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01-01-2009 | Original Article

Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease

Published in: International Journal of Colorectal Disease | Issue 1/2009

Abstract

Purpose

The pathogenesis of hemorrhoidal disease is based mainly on the vascular hyperplasia theory. The aim of this study was to reassess the morphology and the functional mechanisms of the anorectal vascular plexus with regard to hemorrhoidal disease.

Materials and methods

The anorectal vascular plexus was investigated in 17 anorectal and five hemorrhoidectomy specimens by means of conventional histology and immunohistochemistry. Vascular corrosion casts from two fresh rectal specimens were used for scanning electron microscopy. Transperineal color Doppler ultrasound (CDUS) with spectral wave analysis (SWA) was performed in 38 patients with hemorrhoidal disease and 20 healthy volunteers.

Results

The anorectal vascular plexus was characterized by a network of submucosal vessels exhibiting multiple thickened venous vessels separated by distinct sphincter-like constrictions. CDUS and SWA showed significant flow differences in peak velocities (6.8 ± 1.3 cm/s vs. 10.7 ± 1.5 cm/s; P = 0.026) and acceleration velocities (51 ± 4 ms vs. 94 ± 11 ms; P = 0.001) of afferent vessels between the control group and patients with hemorrhoidal disease.

Conclusions

Coordinated filling and drainage of the anorectal vascular plexus is regulated by intrinsic vascular sphincter mechanisms. Both morphological and functional failure of this vascular system may contribute to the development of hemorrhoidal disease.

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Title: Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease
Publication date: 01-01-2009
Published in: International Journal of Colorectal Disease / Issue 1/2009
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-008-0572-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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