Mikelangelo: переводы

→Fig. 2.21 Portal— systemic circulation in the distal part of the rectum

→20 Venous supply of anal canal

→The terms hemorrhoidal/rectal arteries and veins refers to the same vessels.

→Always differentiate between rectal varices and hemorrhoids in cases of bleeding per rectum (Fig.
2.
21).

→Venous flow between anal canal and the rectum is facilitated by systemic and portal circulation.

→Fig.
2.
19 Arterial blood supply of anal canal

→Surgical Significance

→Instead, true rectal varices may develop in portal hypertension (Fig.
2.
20).

→However, hemorrhoidal engorgement is an uncommon occurrence.

→A portocaval anastomosis is formed through communication between the hemorrhoidal plexuses.

→The internal iliac veins receive drainage from inferior and middle hemorrhoidal veins.

→The superior hemorrhoidal vein continues as the inferior mesenteric vein to join the splenic vein [16].

→The veins follow the arterial supply.

→2.11.2 Venous Supply

→The inferior hemorrhoidal artery originates from the internal pudendal artery, a branch of the internal iliac artery’s anterior division.

→According to some authors, it is present only in 40–60% of cases [33, 34].

→They may arise from the internal iliac artery’s anterior division, or the inferior vesical artery, or both.

→Of variable origin, the paired middle hemorrhoidal arteries supply to the distal and middle rectum.

→These branches follow the extramural, transmural, and submucosal course within the rectal wall to form corpus cavernosum recti.

→An extension of the inferior mesenteric artery, the SHA “Superior hemorrhoidal artery” divides into two branches at the third sacral vertebral level (S3) [32].