Abstract
Anal endosonography provides clear images of the internal anal sphincter. Forty-two controls have been studied to establish a range for thickness and echogenicity of the normal internal sphincter, and any physical correlate for these observations. No relationship was found between the thickness of the internal anal sphincter and body weight, height or gender, but there was a significant correlation for thickness with age (p<0.001), the 95% confidence interval being 2.4–2.7 mm <55 years and 2.8–3.4 mm >55 years. Hyperechogenicity of the internal sphincter was significantly associated with an age >55 years (P<0.01) and a thickness >2.8 mm (p<0.05). This has not been observed previously and suggests a histological change in the sphincter as it ages.
Résumé
L'endosonographie anale fournit des images claires du sphincter anal. 42 contrôles ont été étudiés pour établir les variations d'épaisseur et d'échogénicité du sphincter anal interne normal ainsi que toute corrélation avec l'aspect physique du malade. Aucune relation n'a été trouvée entre l'épaisseur du sphincter anal interne et le pois corporel, la hauteur ou le sexe. Par contre, il y avait une corrélation significative de l'épaisseur avec l'âge (p<0,001), l'intervalle de confiance à 95% étant de 2,4–2,7 mm au-dessous de 55 ans et de 2,7–3,4 mm au-dessus de 55 ans. Une hyperéchogénicité du sphincter interne était associée de façon significative avec un âge supérieur à 55 ans (p<0,01) et une épaisseur supérieure à 2,8 mm (p<0,05). Ceci n'avait pas été observé auparavant et suggère des modifications histologiques du sphincter avec l'âge.
Similar content being viewed by others
References
Law PJ, Bartram CI (1989) Anal endosonography: technique and normal anatomy. Gastrointest Radiol 14:349–353
Swash M. Personal communication.
Swash M, Gray A, Lubowski DZ, Nicholls RJ (1988) Ultrastructural changes in internal anal sphincter in neurogenic faecal incontinence. Gut 29:1692–1698
Klosterhalfen B, Offner F, Topf N, Vogel P, Mittermayer C (1990) Sclerosis of the Internal Anal Sphincter-a process of aging. Dis Colon Rectum 33:606–609
Bartolo DCC, Jarratt JA, Read NW (1983) The use of conventional electromyography to assess external sphincter neuropathy in man. J Neurol Neurosurg Psychiatry 46:1115–1118
Bannister JJ, Abouzekry L, Read NW (1987) Effect of aging on anorectal function. Gut 28:353–357
Barrett JA, Brocklehurst JC, Kiff ES, Ferguson G, Faragher EB (1989) Anal function in geriatric patients with faecal incontinence Gut 30:1244–1251
McHugh SM, Diamant NE (1987) Effect of age, gender and parity on anal canal pressures. Digestive Diseases and Sciences 32:726–736
Laurenberg S, Swash M (1989) Effects of aging on the anorectal sphincters and their innervation. Dis Colon Rectum 32:737–742
Law PJ, Kamm MA, Bartram CI (1991) Anal endosonography in the investigation of faecal incontinence. Brit J Surg (in press)
Kamm MA, Hoyle CHV, Burleigh DE, Law PJ, Swash M, Martin JE, Nicholls RJ, Northover JMA. Hereditary internal anal sphincter myopathy causing proctalgia fugax and constipation. Gastroenterology (in press)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Burnett, S.J.D., Bartram, C.I. Endosonographic variations in the normal internal anal sphincter. Int J Colorect Dis 6, 2–4 (1991). https://doi.org/10.1007/BF00703951
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00703951