What Are Anal Sinuses?

The crypts formed by the opening between the anal flap and the lower ends of two adjacent anal columns are called anal sinuses, with a depth of 3 ~ 3mm, and an anal gland opening at the bottom. Anal sinuses often accumulate fecal debris, which is prone to infection and anal sinusitis. In severe cases, it can cause abscesses or red fistulas around the anus.

The crypts formed by the opening between the anal flap and the lower ends of two adjacent anal columns are called anal sinuses, with a depth of 3 ~ 3mm, and an anal gland opening at the bottom. Anal sinuses often accumulate fecal debris, which is prone to infection and anal sinusitis. In severe cases, it can cause abscesses or red fistulas around the anus.

Chinese name

Anal sinus

Foreign name

anal sinuses

Meaning

A recess formed by the anal valve and the lower end of two adjacent anal columns

Number

6-8 in general

Sinus deep

3-5mm

Anal sinus

The anal sinus forms a recess with an upward opening between each anal valve of the anal canal and the lower ends of two adjacent anal columns, which is called anal sinus. The sinus opening is upward, and the anal gland is opened here, and fecal debris is often accumulated in the sinus.

Anal Sinus II. Clinical Anatomy

Treatment of anal fissure

Surgical treatment: It is suitable for old anal fissure, or early anal fissure which is not treated by non-surgical treatment.

(1) Sphincter incision: applicable to early anal fissure without external complications such as external hemorrhoids, anal papillary hypertrophy, and subcutaneous fistula.

Operation points: Make a longitudinal incision 1.5cm away from the anal margin on one side of the anus, deep into the skin, and expose the internal sphincter and diaphragm with a hemostat. Under direct view, clip the lower edge of the sphincter with two vascular forceps and cut it. The incision is generally not sutured, and drainage is induced by gauze. If there is more bleeding in the incision, 1 needle can be sutured.

(2) Incision therapy: suitable for old anal fissure, with external hemorrhoids of connective tissue, anal papillary hypertrophy, etc.

Operation points: Make a longitudinal incision in the middle of the anal fissure, up to the tooth line, and cut off the diaphragm band and some annular fibers of the internal sphincter. The lower end is properly extended downward, and part of the muscle fibers in the lower part of the external sphincter skin is cut off to make drainage easier. At the same time, the external skin hemorrhoids and hypertrophic anal papilla were removed at the same time. Trim the scar tissue on the edge of the ulcer to make it a V-shaped open wound with a large top and a small bottom.

(3) Longitudinal and transverse suture method: applicable to those with old anal fissure and anal canal stenosis.

Main points of operation: Make a longitudinal incision along the midline of the anal fissure, 0.5cm up to the line of the teeth, 0.5cm down the edge of the anus, and cut off the diaphragm band and part of the internal sphincter. Subcutaneous fistula, superficial hemorrhoids, anal papillary hypertrophy, and anal sinusitis were also removed. Trim the wound wound and free the skin at the lower end of the incision to reduce tension and completely stop bleeding. Use a fine silk or absorbable thread to enter the needle from the upper end of the incision, with a little basal tissue, and then pierce the skin from the lower end of the incision.

General treatment

(1) Conditioning diet: foods rich in dietary fiber should be taken to increase stool volume, such as crude cereal products, beans, potatoes, vegetables, fruits, etc .; try to avoid or reduce spicy foods and condiments such as pepper, Cumin, curry, pepper, white wine, etc.

(2) Appropriate taking laxatives: laxatives can soften stools, such as liquid paraffin, laxatives, malen pills, rhubarb tablets, senna leaves, phenolphthalein, and linguine mixture, etc. Please pay attention to the dosage when applying, because the amount Does not work, large amounts can easily cause diarrhea. The mastery of the dose varies widely and should be used as appropriate according to the situation of each patient.

(3) Cultivate regular bowel movements: It is generally recommended to defecate before and after breakfast. For patients with longer bowel movements, self-massage can be performed. Massage method: Start from the right lower abdomen, and gradually go up to the order of the right upper abdomen, upper abdomen, left upper abdomen, and left lower abdomen. The technique is heavier and lighter, and the left lower abdomen is completely relaxed, usually repeated 10 to 20 times. You can also do some other movements that are good for accelerating bowel movements.

(4) Relieve mental tension: Most patients with anal fissures have the fear of defecation. When they do not have bowel movements, they must first tolerate bowel movements. After repeated infestations, they have to defecate, causing dry stools and thick stools. Difficult to excrete, anal pain worsened. In fact, in most cases, the stool of a patient with anal fissure is just a dry head, and then it is normal. Therefore, it is very important for the doctor to explain the process of bowel movements to the patient in order to relieve the patient's nervousness. The author found that many patients with anal fissure surgery still have this psychological disorder of defecation, which leads to patients' unsatisfactory surgical results.

Internal law

Symptoms of blood-heat and intestinal dryness: constipation, 2 to 3 days, dry and hard, anal pain, bloody or dripping toilet paper, red lips; accompanied with fullness of the abdomen, yellowish yellow; red tongue, fur coating Yellow dry, pulse string number. Governing method: clearing away heat and cooling blood, moistening intestines and purging. Recipe: Zengye Chengqi Decoction. Hemorrhage was added to Ulmus pumila, Huaijiao, and Huanghuang charcoal; pain was added to Yinqiao, Yanhusuo, and those with constipation added hemp kernels and whole melon.

Symptoms of Yin deficiency and deficiency: dry stool, several days in a row, periodic anal pain, dripping blood, deep cleft lips, irregular wound margins; dry mouth, dry throat, five upsets; red tongue, less tongue coating Or yellow greasy, pulse count. Governing law: nourishing yin and clearing heat, moisturizing bowel and purging. Recipe: Consistently fried or Runchang Decoction. If you are upset, add Ophiopogon, Polygala, etc., if you have difficulty in stool, add Ma Ren, Quan Gua.

Syndromes of Qi stagnation and blood stasis: anal tingling is obvious, especially after urination; the anus is tightened, and the cracks are purple and dark; the tongue is purple and dark, and the tongue is yellow with pulse strings or astringent. Governing method: regulating qi and activating blood, dissolving blood stasis and clearing collaterals. Recipe: Liumo Decoction. Pain is added to dandelion, safflower, peach kernel, red scallion, etc .; those who have constipation and spleen shell, mirabilite, etc.