Puborectalis syndrome (rectal stenosis due to anorectal spasm)

Abstract

SrEaos~s of the anorectum is classically divided into three categories: congenital, traumatic, inflammatory, and there is a tentative [ourth category termed spasmodic. It is my purpose to establish the need for this fourth category by discussing records <}f patients who have a type of stenosis caused by spasm ot a component of the external sphincter ani muscle. LockhartMummery ~r was aware o[ the existence of such a condition. He revealed its presence not only by digital examination, but by' proctoscoi)y when he visualized such steno:sis in patients who had no evidence ol organic disease of the bowel mucosa. Gabrieff calls attention to a "rare type o[ spasmodic stricture o[ tile anal canal caused by sympathetic overactivity/' Gant s described spastic stenosis caused hy preexisting anal conditions which, if eliminated, would eradicate the sl)asmodic condition.