Mikelangelo: переводы

→The sinusoids strengthen the activity of the anal cushions and result in anal continence by aiding the closure of the anal canal.

→The sinusoids act as a three-way crossroads, taking “blood from the superior hemorrhoidal artery and middle hemorrhoidal arteries, oxygenating
the nonvascular portion of the cushion, and releasing venous blood” to the superior and middle hemorrhoidal vein [8].

→They have been termed corpus cavernosum recti because they make a spongy network similar to the erectile tissue of the
penis.

→These sinusoids lead to the formation of fenestrations (Fig.3.2).

→Lacking muscular walls and lined by endothelium, these are present in the hollow spaces of the anal cushions and are called sinusoids [10, 11].

→It comprises arterioles and venules, forming an arteriovenous network without interposed capillaries.

→3.2.2 Vascular Component of Hemorrhoids formed by the superior hemorrhoidal artery branches.

→Hypervascularization may cause venous stasis in people with
hemorrhoids.

→Fourth—The small caliber of the terminal branches of the supplying arteries.

→These sphincters are absent or nearly flat in patients with hemorrhoids, leading to the arteriovenous
plexus hyperperfusion.

→This sphincter-like structure reduces the arterial inflow, therefore
allowing adequate venous drainage.

→Third—A sphincter-like structure is present in the terminal arterioles.

→The Treitz muscle has two parts: first is the anal submucosal muscle, which
fixes the “cushions to the internal anal sphincter, and the second is the mucosal suspensory ligament,” fixing sinusoids to the conjoined longitudinal
muscle (CLM) [9].

→The weakening and disintegration of these fibers lead to prolapse.

→Second—The fibers of the ligament of Treitz pierce the internal anal sphincter (IAS) and significantly contribute to anchoring the anal cushions.

→First—The connective tissue, which is present between the sinusoids.

→It consists of four anatomical features that maintain the anal cushions in their normal position, which are as follows [6–8]:

→3.2.1 Nonvascular Component of Anal Cushions

→Both these components are essential in the etiopathogenesis of hemorrhoids.

→The anatomy of anal cushions can be described in terms of two components; nonvascular and vascular.