(*) Royal Perth Hospital, University of Western Australia
(**) Dept of Neurology, The Royal London Hospital, London, UK
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Figure 1. –The principal closure mechanism for the anorectum is stretching and narrowing of the rectal tube by posterior muscle forces (arrows) acting against an anus immobilized by puborectalis (PRM) contraction. This action increases the resistance to leakage exponentially inversely with the 4th power of the diameter. LP = levator plate; LMA = longitudinal muscle of the anus. |