Significance of the changes in the structure of the anococcygeal ligament as a possible cause of the development of children’ defecation disorders

Abstract

The work is based on the results of the examination and treatment of 271 patients with defecation disorders, 114 (42,1%) boys, (57,9%) girls who were treated at the surgical departments of the pediatric surgery clinic of National Pirogov Memorial Medical University, Vinnytsia in the period from 2008 to 2018, and were residents of Podilskyi ethnic territorial region, which determined the unity of the peculiarities of life and nutrition. In order to prevent and correct the defecation disorders after destruction of the anococcygeal ligament, the method of restoring its functional capacity was proposed (Patent of Ukraine for Invention No. 115280 “Method for Coccyx Removing”). It is proved that the damaging effect in the area of the traction and contraction mechanism of action on the rectum in 90,0% leads to continence disorders due to changes in the size of the anorectal angle due to the persistent disorders of the anococcygeal ligament function. The developed spacial mathematical model of the anococcygeal ligament function testifies that, when it is destroyed, the change in the anorectal angle value may reach changes in its value up to ≈63°, which distorts the direction of the anal canal and the distal rectum. Restoration by simulating of the anatomical fixation of anococcygeal ligament connection after its damage creates conditions for restoration of its physiological functioning.