Currently, magnetic resonance imaging (MRI) performed on high-magnetic-field scanners is the imaging modality of choice to investigate the anal region for both staging and treatment evaluation purposes, due to its high-detail visualization of the anal canal
and nearby anatomical structures, reliable soft tissue differentiation, noninvasiveness, and not needing special patient preparation [9-11].
The doctor can examine the anus and the anal canal
in the office with the unaided eye or by using a small instrument called an anoscope.
Fistulae result from a peri-anal abscess forming a granulation-lined tract between the anal canal
and the peri-anal skin.
High anal canal
pressure was documented in patients with hemorrhoids (12,13,14), especially in the younger patients.
4th Degree: Haemorrhoids that cannot be reduced into the anal canal
, or are strangulated.
On rectal examination a soft mucocutaneous lesion around 4-5mm were palpable in the anal canal
. Flexible sigmoidoscopy was normal.
Three months after the completion of the treatment, a reevaluation of the disease with endoscopic ultrasound showed an ulcer within the anal canal
extending 1 cm above the dentate line.
Hemodynamic evaluation showed four areas of rectal venous circulation: inflow area (from 10 to 8 cm), downflow area (from 8 to 6 cm), outflow area in the lower rectum (6 to 4 cm), and outflow area in the anal canal
. The EUS appearance in inflow area corresponded with highest point of RVs on endoscopy and in downflow area corresponded with endoscopic presence of multiple submucosal RVs (Figures 2(a), 2(b), and 2(c)).
In patients who don't respond, anal rectonometry may show abnormal defecation, such as an anal canal
that does not relax during defecation.
rumbles down the anal canal
, released from the radiating folds of the
Prior to the surgery, the twins shared the lower abdomen and pelvis, fused uro-genital system, lower back and had one anal canal
Tests and investigations show that the twins share the lower abdomen and pelvis and have a fused uro-genital system, lower back, in addition to sharing one anal canal
. The team is confident that the twins are separable.