Kolorektal Bölge Anatomisi
Özet
Kalın barsak, sindirilemeyen besin artıklarından su ve elektrolit emiliminin gerçekleştiği, çekum, apendiks, kolon, rektum ve anal kanaldan oluşan sindirim sisteminin terminal bölümüdür. Terminal ileumun çekuma açıldığı noktadan başlayarak anüse kadar uzanır. İnce bağırsaktan daha kısa olmasına karşın daha geniş bir lümene sahip olan kalın barsak; haustralar, teniae coli ve omental apendiksler gibi kendine özgü anatomik özellikleri ile ince bağırsaktan ayrılır. Kolon, rektum ve anal kanalın anatomik ve fonksiyonel bütünlüğü, normal dışkılama fizyolojisinin ve fekal kontinansın sürdürülmesi açısından büyük önem taşır. Bu yapılarda görülen doğumsal veya edinsel anatomik anomaliler ile mekanik ya da fonksiyonel obstrüksiyonlar, bağırsak geçişini etkileyerek kabızlık ve dışkılama bozukluklarına neden olabilir. Her ne kadar kolonik motilite bazı olgularda normal sınırlarda olsa da, dışsal veya içsel obstrüktif nedenler dışkı pasajını önemli ölçüde engelleyebilmektedir. Fekal kontinansın sağlanmasında rektum, anal kanal, sfinkter kompleksi ve pelvik taban kasları temel rol oynar. Bu nedenle bu bölümde, öncelikle kalın barsağın distal segmentlerinin anatomik özellikleri ele alınacak; ardından rektum, anal kanal, sfinkter kompleksi ve pelvik taban yapılarının kontinans ve defekasyon fizyolojisindeki rolleri ayrıntılı olarak incelenecektir.
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