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At least 397 records · Page 22Linked to original sources
PubMed1976

Re-instatement of regular defecation routines in a four-year-old boy.

A four-and-a-half year old boy was withholding faeces for up to eight days. A programme of positive reinforcement contingent upon his being placed on the toilet according to a schedule was introduced. An operant technique of immediate, positive reinforcement was utilised to reward bowel movements. Results indicate that the reinstatement of a two-daily routine of defection was achieved after 48 days. The programme was introduced and maintained by the child's mother with no outside intervention in the routine.

Child Behavior Disorders↗
PubMed2001

[Complex radiologic investigation for disorders of defecation in children].

The work presents findings obtained by the radial examination of the anorectal area including routine methods such as irrigography and balloon proctography as well as modern technologies such as endorectal ultrasonography with a transducer of high resolution (7.5 MHz) and computed tomography in 250 children with more common syndromes in colonoproctology: constipation and incontinence of feces. Results of the endosonographic investigation of the normal sphincter apparatus in children are described. It is confirmed that endosonography is of great importance for the detection of the isolated intumescence of the anal sphincter. Computed tomography is also necessary for traumas of the anorectal area in children.

Adolescent↗
PubMed1975

New concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. II. Anatomy of the levator ani muscle with special reference to puborectalis.

A study of the surgical anatomy of the levator ani muscles, with special stress on the puborectalis, was performed on 22 cadaveric specimens. The study comprised dissection and microscopic examination. The levator ani was found to consist of two portions only: pubococcygeus and iliococcygeus, the puborectalis being a part of the external anal sphincter. Both levatores decussate at the anococcygeal raphe, which represents a "decussation line" and not a site of insertion for the muscle fibers. A "digastric" pattern of the levator is demonstrated, which is responsible for the harmonic nature of the function of the muscle bundles on each side of the pelvis. The levator hiatus was found to be formed of the medial borders of the pubococcygeus, , and not the puborectalis. A "hiatal ligament" was identified, stretched between the edges of the levator hiatus and the intrahiatal viscera. The role of the pubococcygeus in anal fixation is discussed, and a new concept that the puborectalis does not belong to the levator ani but constitutes na integral portion of the external and sphincter. The puborectalis and the deep external anal sphincter were found to be fused together and identical from the morphologic, histologic, and functional points of view as well as with respect to innervation. Both form a single U-shaped loop which is given the name "top loop."

Adolescent↗
PubMed1976

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. IV. Anatomy of the perianal spaces.

A study of the perianal spaces was performed in 22 cadaveric specimens using dissection and microscopic examination. Six spaces could be recognized: subcutaneous, central, intersphincteric, ischiorectal, pelvirectal, and submucous. A mention of the central and intersphincteric spaces could not be traced in the literature. The anatomic relations and communications of the perianal spaces are discussed. The central space occupies the area between the longitudinal muscle termination and the base loop of the external anal sphincter. It is the headquarters of all of the perianal spaces as it communicates with all of them. The intersphincteric spaces lie along the longitudinal anal muscle. They constitute the main tracks for extension of pus along the anal canal. The ischiorectal space communicates directly with main tracks for extension of pus along the anal canal. The ischiorectal space communicates directly with the subcutaneous space without the intervention of a septum. The pelvirectal space communicates with the perianal skin through the intersphincteric spaces. The author failed to demonstrate the musculus submucous space; in its place a collagenous internal anal septum could be identified. Furthermore, no trace for the suspensory ligament of Parks was detected; the lower anal lining was found to be pulled by the medial central septum derived from the central tendon.

Adolescent↗