TRANSPOSITION OF THE ANTROPYLORUS FOR ANAL INCONTINENCE - AN EXPERIMENTAL-MODEL IN THE PIG

An experimental model in the pig rendered incontinent of feces was dev eloped to assess the sphincteric activity of the transposed antropylor us. In the control group, normal defecation was studied clinically, ra diologically, and manometrically. Nineteen 7- to 10-week-old pigs were rendered incontinent by resection of 20 cm of colon and rectum to bel ow the dentate line. The antropylorus was prepared on its own blood su pply and transposed to the anus, initially with a colostomy, which was closed 15 to 21 days later. Clinically these pigs passed semisolid st ool in a piecemeal fashion. Contrast defecography showed hold-up at th e pylorus, reflux of contrast into the colon, with pyloric contraction independent of antral stimulation. Manometry showed pyloric contracti on with rise in antral pressure and independence. The authors conclude that transposition of an antropyloric segment to the anus provides a sphincter-like mechanism and could have application in fecal incontine nce. Copyright (C) 1995 by W.B. Saunders Company