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In a prospective consecutive study of 40 patients with anal fissure we analysed the anal sphincter function at rest and rectal distension. Healthy persons with comparable age and sex distribution were controls. The anal pressures were registered with thin water perfused catheters (2 ml/min). Our patients with anal fissure showed significant elevation of anal pressures at rest along the whole length of anal canal. During rectal distension only the distal part of anal sphincter (up to a level of 2 cm from the anocutaneous line) showed a spasm with reduced relaxation. Our results are useful for operative therapy, since lateral internal sphincterotomy corresponds very well to functional pathomechanism of anal fissure.

In 16 patients operated on for mechanically caused ileus and in 12 control patients (cholecystectomy) local PO2 of the small bower wall was determined by means of a multiwire Pt surface electrode constructed by Kessler and Lübbers. The ileus patients showed an increased pulse rate of 110 (90-115) vs 90 (80-110) beats/min and creatinine levels of 1.06 (0.79-1.45) vs 0.80 (0.70-0.88) mg%. (mean, 1.-3. quartile, P less than 0.05). Local PO2 values of the serosal site of the small bowel were significantly reduced in patients with ileus compared to the control group [22.5 (12.5-35) vvs 61.2 (53.0-71.0) torr.] Hypoxia of the bower in mechanically caused ileus could be demonstrated by local PO2 determination and underlines the demand of early decompression.

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