SIGNIFICANCE OF THE CHANGES IN THE STRUCTURE OF THE ANOCOCCYGEAL LIGAMENT AS A POSSIBLE CAUSE OF THE DEVELOPMENT OF CHILDREN’ DEFECATION DISORDERS

Abstract

INTRODUCTION Morphological study of the state of the tissues of the perineum and distal colon’s parts (DCP), the examination of the anatomical features of their muscles and fascial-cellular spaces from the position of macroand microscopic structure in modern medicine is relevant and promising, as it can provide an comprehensive answer and fully discover the versatility of their anatomical functionality 1 . In adults, the coccyx usually consists of three to five vertebrae, which are connected by a cartilage disc to the fifth sacral vertebra. Sinostasis of the coccygeal vertebrae begins approximately at the age of twelve from bottom to top. Muscles and ligaments that participate in the functioning of the urinary system and the DCP are attached to the coccyx. The pubiccoccygeal, iliac-coccygeal and coccygeal muscles form the lift muscle of the anus, and the anococcygeal ligament is interwoven into the fibers of the rectal sphincter. The anatomical features of the female pelvis include the fact that the sacral bone along with the coccyx is deflected more to the back, so that the coccyx is located more superficially than in men. The angle between the sacrum and the coccyx is normally 2 150 ± 3.7°. The anatomic-functional unity of the fasciae, ligaments and muscles of the DCP forms an elastic suspended structural system that promotes the formation of natural bends (ano-rectal and sigmo-rectal angles) responsible for the implementation of both the normal act of defecation and the function of physiological abstention. In case of any component disorder of this DCP system, or change in the size of the sacroiliac angle, factors that contribute to the formation of conditions for dysfunction of the rectum and pelvic bottom appear. The applied fascias value is conditioned that they, being the