MICROSCOPIC CHARACTERISTICS AND ITS IMPLICATION OF OPERATED TISSUES OF ANAL FISTULAE

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  • 切除痔ろうろう管の組織像の特徴とその意義

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We microscopically investigated tissues extracted from external through internal orifice of anal fistulae, categorized with 7 tracts with extended abscess cavity, 36 fistulous tracts with abscess, 25 fistulous tracts without abscess and 21 cicatrized fistulae. Anal glands were detected in 60% in these resected fistulous tissues and were compared with anal glands from 19 operated hemorrhoids as a control. The subjected anal glands were constructed with columnar epitherium and/or squamous epitherial metaplasia. In the tracts with extended abscess cavity, and fistulae with or without abscess, size of columnar cells and outside and inside diameters of columnar epitherial ducts were significantly greater than those of the control. In the squamous metaplastic anal glands, outside diameter of the ducts was significantly larger in the tracts of extended abscess cavity and fistulae with abscess than those of the control. Proportion of squamous epitherial glands was increased in the cicatrized anal fistulae. It is speculated that, in cryptglandular origin, anal fistulae are formed by repeated infection causing fecal contents trespassing through the enlarged columnar epitherial anal glands. Anal ducts are closed by metaplastic squamous epithelium, and subsequently, inflammation is ceased by preventing the invasion of faeces. Conversely, abscess expands into the surrounding adipose tissue by affecting inflammation.

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