Anatomy, Physiology, and Pathophysiology of Hemorrhoids
The understanding of anatomy, physiology, and pathophysiology of hemorrhoids is fundamental to selecting an appropriate treatment of hemorrhoids, improving treatment outcomes, developing novel methods for managing hemorrhoids, and preventing recurrent diseases. This chapter deals with some essential knowledge and current views of applied anatomy, anorectal physiology, and pathophysiology of hemorrhoids – which includes four main concepts of hemorrhoid formation: sliding anal cushions (loss of fixation network), vascular abnormality (dysregulation of vascular tone, high arterial blood flow, venous hypertension of anorectal vascular plexus, vascular hyperplasia, and neovascularization), rectal redundancy, and an increased pressure on anorectal vascular plexus.
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