Pediatric Surgery International

, Volume 17, Issue 7, pp 521–523

The treatment of internal anal sphincter achalasia with botulinum toxin

  • Antonio Messineo
  • Daniela Codrich
  • Margherita Monai
  • Stefano Martellossi
  • Alessandro Ventura
ORIGINAL ARTICLE

DOI: 10.1007/s003830100583

Cite this article as:
Messineo, A., Codrich, D., Monai, M. et al. Pediatr Surg Int (2001) 17: 521. doi:10.1007/s003830100583

Abstract.

Internal anal sphincter (IAS) achalasia is a disorder of defecation in which the IAS fails to relax. Botulinum toxin (BT), which has been successfully used to relax the anal and lower esophageal sphincters, was injected twice into the IAS of one adolescent and three infants with manometric, radiologic, and in 2 cases histochemical diagnosis of anal achalasia; in the adolescent a third injection was necessary. Spontaneous defecation was achieved in all patients following the second injection. In one case a diagnosis of short-segment Hirschsprung's disease was obtained after the second injection. Local infiltration of BT into the IAS proved effective in the treatment of IAS achalasia. Double-blind studies and longer follow-up periods are needed to better evaluate these preliminary results and define the limits of this promising therapy.

Keywords Internal anal sphincter achalasia Botulinum toxin   Hirschsprung's disease  Anal sphincterotomy   Constipation 

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • Antonio Messineo
    • 1
  • Daniela Codrich
    • 1
  • Margherita Monai
    • 1
  • Stefano Martellossi
    • 2
  • Alessandro Ventura
    • 2
  1. 1.Department of Pediatric Surgery, IRCCS “Burlo Garofolo,” via Dell'Istria 65/1, 34100 Trieste, ItalyIT
  2. 2.Department of Pediatrics, IRCCS “Burlo Garofolo,” Trieste, ItalyIT

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