The transverse portion of the levator ani has five kinds of shapes in the different-coronal sections of the pelvis, which changes from basin to dome in a lying position. The puborectalis is outside the vertical portion and not part of the levator ani.

The anus descends and there is no muscle to lift it during defecation; the results indicate that the puborectalis lifts the anus during squeeze. The levator ani muscle does not lift the anus; its main function is to open the genital hiatus and the anus during defecation. The main function of the puborectalis muscle is to shut the genital hiatus and anus during squeeze.

Following the untimely death of Professor Ahmed Shafik, the authors decided to analyse his published work on the anatomy and physiology of the anorectal area, reconciling this body of data with current imaging and physiological techniques. All available papers as indexed by PubMed pertaining to the anorectal area were obtained and reviewed. The anatomical data was compared with historical representations and current new imaging modalities. The original 'triple-loop' theory of the anatomical disposition of the external anal sphincter has been confirmed by coronal and coronally reconstructed imaging modalities. There is variance between the Shafik and other descriptions of the anatomy of the longitudinal muscle and its importance in the definition of perianal spaces which are important in the spread of perirectal sepsis and in intersphincteric rectal dissection. Current dynamic defaecography would suggest a more complex levator plate function in squeeze and straining than that originally suggested by Shafik as a primary defaecatory role for the levator muscle. The body of work by Professor Shafik has reorganized our understanding of the external anal sphincter and the function of the levator during defaecation. Future studies should assess anatomical and physiological variances using new technology in health and in specific disease states.

Multiplanar body-coil MRI studies can show anorectal fat spaces and musculature simultaneously, allowing fat spaces and musculature to serve as mutual referents. The results of imaging of the anal region with this method are different from previous imaging descriptions and may provide a more accurate and systemic description of the anal region structures than was previously available.

ZusammenfassungFragestellung: Der zu frühe Tod von Professor Ahmed Shafik veranlasste die Autoren, eine Analyse seiner veröffentlichten Arbeiten zur Anatomie und Physiologie des Anorektums vorzunehmen und dabei seine Daten mit den aktuellen bildgebenden und physiologischen Untersuchungen abzugleichen.Methodik: Alle bei PubMed katalogisierten verfügbaren Arbeiten, das Anorektum betreffend, wurden gesichtet und beurteilt. Die anatomischen Daten wurden mit historischen Darstellungen und aktuellen Bildgebungsmethoden verglichen. Die ursprüngliche "Triple Loop"-Theorie der anatomischen Beschaffenheit des externen analen Sphinkters wurde durch koronare und koronar rekonstruierte Abbildungen bestätigt.Ergebnisse: Es gibt einen Unterschied zwischen den Beschreibungen von Shafik und anderen Autoren hinsichtlich der Anatomie des Längsmuskels und dessen Bedeutung bei der Definition perianaler Räume, die eine wichtige Rolle bei der Ausbreitung perirektaler Entzündungen und bei intersphinktären rektalen Präparationen spielen. Die aktuelle dynamische Defäkographie würde eine komplexere Levatorfunktion beim Pressen und Kneifen nahelegen, als ursprünglich von Shafik angenommen wurde, der die Funktion des Levatormuskels in einer primären Entleerungsrolle sah.Schlussfolgerung: Die Arbeiten von Professor Shafik waren grundlegend für unser heutiges Verständnis des externen analen Sphinkters sowie der Funktion des Levatormuskels während der Defäkation. Weitere Studien sollten die anatomischen und physiologischen Unterschiede unter Einsatz neuer Gesundheitstechnologie und in spezifischen Krankheitsstadien untersuchen. coloproctology Standorte Zbar AP, et al. Shafiks Arbeiten zur anorektalen Morphologie und Funktion 270 coloproctology 31 · 2009 · Nr. 5Abstract Purpose: Following the untimely death of Professor Ahmed Shafik, the authors decided to analyse his published work on the anatomy and physiology of the anorectal area, reconciling this body of data with current imaging and physiological techniques.Methods: All available papers as indexed by PubMed pertaining to the anorectal area were obtained and reviewed. The anatomical data was compared with historical representations and current new imaging modalities. The original "triple-loop" theory of the anatomical disposition of the external anal sphincter has been confirmed by coronal and coronally reconstructed imaging modalities. Results:There is variance between the Shafik and other descriptions of the anatomy of the longitudinal muscle and its importance in the definition of perianal spaces which are important in the spread of perirectal sepsis and in intersphincteric rectal dissection. Current dynamic defaecography would suggest a more complex levator plate function in squeeze and straining than that originally suggested by Shafik as a primary defaecatory role for the levator muscle. Conclusion:The body of work by Professor Shafik has reorganized our understanding of the external anal sphincter and the function of the levator during defaecation. Future studies should assess anatom...