Anal Papilla Research Articles

Morphometric evaluation of Aedes aegypti (Linnaeus, 1762) and Culex quiquefasciatus (Say, 1823) (Diptera: Nematocera: Culicidae) of different metamorphosis stages

Morphometric comparison of Aedes. aegypti and Culex. quiquefasciatus larval instars and pupae were done through the measurements of total body length, length of head, thorax and abdomen as well as length and width of different external body parameters. From linear regression of the data from different larval instars showed that the important morphological features were the size of the head, thorax and abdomen of the Ae. Aegypti and Cx. Quinquefasciatus. They increased significantly with the advanced metamorphosis stages (p≤0.05). Size of the external larval organs viz. antennae, comb spine, siphon, anal papilla were also significantly (p≤0.05) increased during stages of metamorphosis. Bangladesh J. Zool. 51(3): 329-343, 2023

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures.

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures.

Attack on crypsis: Molecular and morphological study of Dendrodoris Ehrenberg, 1831 (Mollusca: Gastropoda: Nudibranchia) from the Mediterranean Sea and Northern Atlantic Ocean reinstates Dendrodoris temarana Pruvot-Fol, 1953.

The genus Dendrodoris is ascribed to the family Dendrodorididae, whose members are characterized lacking spicules in the dorsum as well as a radula, one of the most important taxonomic traits to distinguish and define nudibranch species. The absence of this taxonomic character makes difficult to delineate species based on morphologic traits, and consequently, several cryptic species may remain unreported resulting in a potential underestimation of the real diversity of the genus. Species delimitation analyses based on molecular data constitute an important tool to unveil cryptic species, especially when morphology may be misleading. However, for the genus Dendrodoris, only two molecular studies have been performed to date, both based on Indo-pacific species and the molecular marker COI. In the present study, we performed a multilocus approach using the molecular markers COI, 16S and H3 based on 47 Dendrodoris specimens from the North Atlantic Ocean and Mediterranean Sea. As a result, we detected monophyly for five of the previously accepted species plus the presence of an unidentified one. Using morphological and anatomical data from 14 additional individuals and a review of the literature, we verified this unidentified species is the previously synonymized species Dendrodoris temarana Pruvot-Fol, 1953, and we redescribe it morphologically (chromatic pattern, gills, rhinophores and anal papilla), anatomically (neural, circulatory, digestive and reproductive systems), and biologically herein. D. temarana is differentiated by its chromatic pattern, previously thought to be intraspecific variation of D. grandiflora (Rapp, 1827), D. limbata (Cuvier, 1804) and D. herytra Valds Ortea in Valds, Ortea, Avila Ballesteros, 1996, and therefore it is considered a pseudocryptic species. This study increases the number of valid species in the North Atlantic and Mediterranean to nine and confirms the importance of integrative taxonomic approaches to resolve the identification of cryptic species in complex groups.

STUDY TO EVALUATE THE EFFECT OF AABZAN OF WARM WATER IN CASES OF INSHEQAQ MAQADHAAD (ACUTE ANAL FISSURE)

Insheqaq Maqadhaad (Acute Anal fissure) is an ulcer in the longitudinal axis of the lower anal canal. Clinical presentation of patients includes Common in middle aged w omen, not in elderly. Constipation, bleeding discharge and stools are hard pellet like and there is drop of blood or streaks of fresh blood. Chronic fissures are characterized by a hypertrophied anal papilla internally and a sentinel tag externally (both consequent upon attempts at healing and breakdown), between which lies the slightly indurated anal ulcer overlying the fibers of the internal sphincter. When chronic, patients may also complain of itching secondary to irritation from the sentinel tag, discharge from the ulcer or discharge from an associated intersphincteric fistula, which has arisen through infection penetrating via the fissure base. In Aabzan Therapy only hips are immersed in medicated water, level of water should not be above navel (umbilicus). This therapy is very common and is used to relieve pain and discomfort of lower and upper limbs. It is indicated in Anal fissure, hemorrhoids, rectal prolapsed, uterine prolapsed, oligomenorrhoea, hysteria, dysentery, diarrhoea, cystitis, uterine cramps, vaginitis, IBS and prostitis. Present study was conducted on 30 Lord's anal dilatation post operative patients of Insheqaq Maqadhaad (Acute Anal fissure) to evaluate the effect of Aabzan of warm water in cases of InsheqaqMaqadhaad(Acute Anal fissure). The significant reduction in various scores was found after the completion of the study.

A new theory on the cause of anal fissure – impaction theory

The internal hemorrhoid, rectal tumor, hypertrophic anal papilla, and secret fecal mass are regarded as the blocks embedded in the rectum. The above blocks hinder defecation, which will inevitably lead to excessive opening of the anal caliber. Once the limit is exceeded, the skin of the anal canal will tear and form anal fissure. Based on the study of historical evolution, hypothesis reasoning, clinical verification and comparison with other theories, a new concept of anal fissure etiology–impaction theory is proposed. The so-called impaction theory refers to the impaction (various primary lesions) in anorectum, which hinders defecation. When defecating, the anal canal expands beyond the limit, and the whole layer of anal canal skin splits, that is to say, anal fissure is formed.

Morphological observation of the Wohlfahrtia magnifica in mongolia plateau

The Wohlfahrtia magnifica living in Mongolia plateau was the only pathogen of Bactrian camel vaginal myiasis. In this paper, the head, thorax, abdomen, wing, leg and male and female identification of W. magnifica were observed and described by ultra depth imager. The W. magnifica was a kind of medium and large flies and covered with silver- gray pollen. The head had compound eyes, mouthparts, antenna, and a large amount of bristles. The dorsal of thorax was covered with silver-gray pollen and the mesothorax was developed, the legs, wings and halter were attached to thorax. The abdomen was divided into five abdominal segments, its dorsal had symmetrical black patch and the ventral was gray-black.The wings were composed of veins and cells. The leg was divided into propodium, mesopodium and metapodium. The structure of terminalia was difference between male and female, the female flies had serration end edges in the caudal end of abdominal segment and its terminalia was concave and the anal papilla was grayish white. To the male flies, its end edges of the caudal end of abdominal segment was smooth and its terminalia was convex, the dark yellow saccular process was shaped like a spoon swollen.This results would enrich people’s understanding of the biological characteristics of W. magnifica in the Mongolia Plateau.

1522 Energy Therapy—An Alternative Treatment of Anal Fissures

INTRODUCTION: Energy Therapy has been a well known non-surgical, minimally invasive treatment option for symptomatic grades I and II internal hemorrhoids. This treatment has not yet been studied in anal fissures refractory to medical therapy. Anal fissures, like hemorrhoids, can severely disrupt the quality of life for patients. Currently, only a few non-surgical treatments are available for anal fissures which involve conservative and supportive measures that include: increasing dietary fiber intake, stool softeners, sitz baths, topical analgesics or vasodilators. The gold standard for chronic anal fissures (CAF) refractory to medical therapy is treatment with internal sphincterotomy. Unfortunately with this treatment there is a chance of relapse and a risk of anal incontinence. We propose the use of hemorrhoid energy therapy (HET) with bipolar cautery as a safer, less invasive and effective therapy for recurrent anal fissures refractory to conservative management. CASE DESCRIPTION/METHODS: 53 year old obese heterosexual man presented with bright red blood per rectum for two months managed outpatient for chronic constipation. Rectal examination revealed a large clot with anal tenderness and few internal hemorrhoids. Colonoscopy revealed 3 internal non-bleeding hemorrhoids and slow oozing bleeding anterior anorectal fissure. The anal fissure exhibited characteristics of chronicity with base exposing to the internal anal sphincter, hypertrophic anal papilla and sentinel pile. HET therapy with bipolar cautery was applied to the bleeding anal fissure. The tissue consisting of anal fissure in bowel wall was compressed in a parallel fashion and bipolar radiofrequency energy was delivered until the temperature reached 55 C or 131 F (5-20 seconds) for approximately 1.5 to 2 seconds. DISCUSSION: The delivery of energy to a targeted region with temperatures between 50 to 55 C along with compression of the tissue can help obtain homeostasis for bleeding or CAF along with change of histology to mild scarring with fibrosis and occlusion of blood supply which would result in healing of the fissure. This intervention using bipolar cautery which could be an alternative treatment as a safer, less invasive and effective therapy for recurrent anal fissures refractory to conservative management prior to considering surgery. Our patient was followed up 2 years after the procedure with no recurrences of anal fissures or rectal bleeding, and reported improved quality of life with no complications from the procedure.

Studies on the Functional Morphology of the Digestive System of the Fresh Water Thiarid Snail, Mieniplotia scabra (MÜLLER, 1774), Family Thiaridae New to Egypt

Detailed functional morphology of the digestive system of the thiarid snail Mieniplotia scabra is given in this study. The basic anatomical structure is consisting mainly of the mouth opening, the buccal mass, the salivary gland, the esophagus, the stomach, the style sac, the digestive gland, the intestine and the rectum. It confirms to that of any other style – bearing caenogastropods. The muscular structure of the buccal mass of the present snail has been macro and micro anatomically studied. Their structure has been correlated with their function and with the mechanism of feeding. It has been compared with the corresponding constituents of other caenogastropods mainly in family Thiaridae. The esophagus is an almost long tube and divided into three parts; pro - mid-, and post esophagus. The absence of the esophageal pouches and the crop of the alimentary canal of the present species reveal that the present snail is not adapted for cilliary feeding. The main structure of the stomach and the style sac resembles to those described in other thiarid snails. The detailed microanatomy and function of the epithelial lining of the digestive tubules of the digestive gland vary from one group to another thiarid snail according to the mode of feeding and digestion. Thus, in the present style - bearing microphagous herbivorous species the cells of the digestive tubule can be found in any one of the following three phases of activity; absorption, digestion and excretion. Therefore, they may be mainly adapted for intracellular digestion, absorption and excretion. The pro - intestine with its typhlosole, the post - intestine and the rectum have a simple histological structure; each being basically formed of a simple ciliated columnar epithelium with mucus-secreting cells and an outer muscular coat. The anal papilla characterized by the relatively thick muscular coat and long cilia of the epithelial lining.

Efficacy in the use of local anesthesia in patients with surgical intervention for the resolution of anorectal pathologies

A prospective, comparative, longitudinal study was conducted in the period from April 2016 to January 2017 in order to determine the efficacy of local anesthesia for the surgical resolution of anorectal pathologies in surgically operated patients who attended the General University Hospital “Luis Gomez Lopez. Thus, the population was composed of patients with anorectal pathologies of low complexity, with no previous anorectal surgical history (Hemorrhoids, anal fissure, perianal fistula, hypertrophic anal papilla, perianal condyloma acuminata), which were agreed to be included in this study, without contraindications for use of local anesthesia. A non-probabilistic, intentional sample was made up of 30 patients and the anesthetic protocol was administered following an anesthetic protocol of perianal local anesthesia using anesthetic mixture (70% of 2% lidocaine+30% of 0.5% bupivacaine) quantifying pain tolerance during the intraoperative period on the first and fifth postoperative days, as well as any adverse effects. The results were expressed in absolute numbers and percentages; a good tolerance to pain was observed with some differences related to the sex of the individuals studied; no complications were observed.

Cap-assisted endoscopic sclerotherapy for hemorrhoids: a prospective study (with video)

Objective To evaluate the methodology, feasibility, safety and efficacy of cap-assisted endoscopic sclerotherapy (CAES) for hemorrhoids. Methods Patients with grade Ⅰ to Ⅲ internal hemorrhoids underwent CAES from September 2014 to May 2016. According to the methodology of CAES, reasons for blooding were identified and polypectomy and excision of anal papilla fibroma was performed. Efficacy, intraoperative and postoperative complications and patient satisfaction were evaluated during and after CAES. The follow-up was more than three months. Results A total of 48 patients with grade Ⅰ to Ⅲ internal hemorrhoids underwent CAES, including 25(52.1%) patients with grade Ⅰ, 21(43.8%) patients with grade Ⅱ, and 2(4.2%) grade Ⅲ. During the whole procedure of CAES, colon and terminal ileum examination was performed in 48(100.0%) patients, polypectomy was performed in 14(29.2%) patients, excision of anal papilla fibroma was performed in 1(2.1%) patient, excision of external hemorrhoids was performed in 1(2.1%) patient, biopsy for the polyps on dentate line was performed in 2(4.2%) patients, and sclerotherapy for rectal mucosal prolapse was performed in 2(4.2%) patients. No bleeding was observed during and after CAES. Infection occurred in one (2.1%) patient, who recovered with a one-week anti-infective therapy. One (2.1%) patient claimed mild tenesmus within four days after CAES. No complications were observed within the three-month follow-up. All patients (100.0%) were satisfied with this novel procedure. Conclusion CAES, as a novel endoscopic sclerotherapy, is a safe and effective endoscopic therapy with high patient satisfaction for internal hemorrhoids. Key words: Hemorrhoids; Cap-assisted endoscopic sclerotherapy; Colonoscopy

Cap-assisted endoscopic sclerotherapy for hemorrhoids: Methods, feasibility and efficacy.

To evaluate the methodology, feasibility, safety and efficacy of a novel method called cap-assisted endoscopic sclerotherapy (CAES) for internal hemorrhoids. A pilot study on CAES for grade I to III internal hemorrhoids was performed. Colon and terminal ileum examination by colonoscopy was performed for all patients before starting CAES. Polypectomy and excision of anal papilla fibroma were performed if polyps or anal papilla fibroma were found and assessed to be suitable for resection under endoscopy. CAES was performed based on the requirement of the cap, endoscope, disposable endoscopic long injection needle, enough insufflated air and sclerosing agent. A total of 30 patients with grade I to III internal hemorrhoids was included. The follow-up was more than four weeks. No bleeding was observed after CAES. One (3.33%) patient claimed mild tenesmus within four days after CAES in that an endoscopist performed this procedure for the first time. One hundred percent of patients were satisfied with this novel procedure, especially for those patients who underwent CAES in conjunction with polypectomy or excision of anal papilla fibroma. CAES as a novel endoscopic sclerotherapy should be a convenient, safe and effective flexible endoscopic therapy for internal hemorrhoids.

Internal sphincterotomy versus topical nitroglycerin ointment for chronic anal fissure

Anal fissure is a common benign condition. An anorectal problem is defined as a split in the anal canal mucosa that extends from the dentate line to the anal verge. Chronic anal fissure is defined by a history of symptoms present for more than 2 months' duration and with a triad of external skin tags, namely, a hypertrophied anal papilla, an ulcer with rolled edges, and a base exposing the internal sphincter. Because complications such as incontinence are associated with surgical treatment, chemical sphincterotomy is currently favored. The objective of this study is to compare the difference in outcome between open partial lateral anal sphincterotomy and application of topical 0.2% nitroglycerin ointment for the treatment of chronic anal fissure. This was a quasi-experimental study carried out between January 16, 2007 and January 15, 2008 in the Surgical Department of Jinnah Hospital, Lahore, Pakistan. Sixty consecutive cases with a clinical diagnosis of chronic anal fissure were recruited in the study. All recruited patients met the study inclusion criteria and were randomly assigned to one of the two groups. Group A was managed conservatively using topical 0.2% nitroglycerin ointment, whereas Group B underwent open partial lateral anal sphincterotomy. Both groups were followed up at 1 week, 2 weeks, 4 weeks, and 6 weeks after the treatment. All the patients complained of pain. A total of 43 (71.7%) patients had pain with constipation, whereas 31 (51.7%) patients had bleeding per rectum. Upon clinically examining the anal area, tenderness was elicited in all 60 (100%) patients. Group A included 30 (11 females and 19 males) cases treated with topical 0.2% nitroglycerin ointment and Group B included 30 (11 females and 19 males) cases who underwent open partial lateral anal sphincterotomy. In Group A, only 15 patients with fissures were successfully treated (50%). By contrast, 28 (93%) patients with fissures in Group B were successfully treated, and only two (7%) remained uncured. These two patients (6.6%) in Group B suffered from incontinence due to flatus and feces as a complication of the procedure. This quasi-experimental study demonstrates that open partial lateral internal sphincterotomy is superior to topical 0.2% nitroglycerin application in the treatment of chronic anal fissure, with good symptomatic relief, high rate of healing, fewer side effects, and a very low rate of early continence disturbances.

Benign fibrous histiocytoma presenting as anal canal polyp: first case report

Nonepithelial and nonmelanocytic anal neoplasms are uncommon. The majority are mesenchymal tumors, most of which are malignant sarcomas, particularly leiomyosarcomas and gastrointestinal stromal tumors. Benign mesenchymal anal neoplasms are even rarer. The most common reported cases were anal leiomyomas, granular cell tumors, fibroadenomas, and xanthogranulomas. Benign fibrous histiocytomas (BFHs) or dermatofibromas are common mesenchymal cutaneous tumors that occur in different sites and at any age. Review of the literature did not show previous reports of BFH arising in the anal canal region. We report the first case of a solitary BFH, an unexpected occurrence of a common tumor type presenting as a polyp in an unusual site such as the anus. This rare occurrence can present diagnostic challenges for the surgeons and pathologists. Clinically, it can be confused with the usual anal tags, fibroepithelial polyps, or hemorrhoids. Benign fibrous histiocytoma is a neoplasm with a potential of local recurrence and, therefore, carries certain clinical implications for the patients' management and follow-up when compared with the common nonneoplastic causes of anal polyps such as the anal tags of anal fissures, hemorrhoids, or fibroepithelial papilla. Histologically, it should be differentiated from other histiocytic lesions. This can be resolved by the application of certain histologic features with the appropriate immunohistochemical markers taken within the correct clinical context.

Effect of Chronic Anal Fissure Components on Isosorbide Dinitrate Treatment

Chronic anal fissure is diagnosed in the presence of persistent symptoms: The classic triad includes a linear mucosal tear exposing the internal sphincter fibers, hypertrophied anal papilla, and a sentinel skin tag. Thus, chronic anal fissure can be divided into three components: the fissure itself; hypertrophied anal papilla; the sentinel skin tag. Not every chronic anal fissure has all three components; some have two components, and others present with only a persistent fissure. The success rate of medical treatment for chronic anal fissure is reported as 42-86 %. In this study, we intended to observe the effect of said components on healing with isosorbide dinitrate treatment. A total of 105 patients with chronic anal fissures were admitted and were divided into three groups. Patients in group I had a single component (only the fissure with a linear mucosal tear exposing the internal sphincter fibers); group II had two components (skin tag or hypertrophied papilla in addition to the fissure); group III had all three components (fissure, skin tag, hypertrophied papilla). Isosorbide dinitrate 0.25 % was applied three times a day. The success rates in the study groups were 93, 74, and 64 %, respectively. The success rate was significantly higher for group I than for groups II and III. Chronic anal fissure components should be considered when evaluating the success rates of studies reporting the results of various medical treatments. The number of components seems to be an important factor that affects the results of isosorbide dinitrate treatment.

Optimal treatment duration of glyceryl trinitrate for chronic anal fissure: results of a prospective randomized multicenter trial

BackgroundChronic anal fissure (CAF) is a painful condition that is unlikely to resolve with conventional conservative management. Previous studies have reported that topical treatment of CAF with glyceryl trinitrate (GTN) reduces pain and promotes healing, but optimal treatment duration is unknown.MethodsTo assess the effect of different treatment durations on CAF, we designed a prospective randomized trial comparing 40 versus 80 days with twice daily topical 0.4% GTN treatment (Rectogesic®, Prostrakan Group). Chronicity was defined by the presence of both morphological (fibrosis, skin tag, exposed sphincter, hypertrophied anal papilla) and time criteria (symptoms present for more than 2 months or pain of less duration but similar episodes in the past). A gravity score (1 = no visible sphincter; 2 = visible sphincter; 3 = visible sphincter and fibrosis) was used at baseline. Fissure healing, the primary endpoint of the study, maximum pain at defecation measured with VAS and maximum anal resting pressure were assessed at baseline and at 14, 28, 40 and 80 days. Data was gathered at the end of the assigned treatment.ResultsOf 188 patients with chronic fissure, 96 were randomized to the 40-day group and 92 to the 80-day group. Patients were well matched for sex, age, VAS and fissure score. There were 34 (19%) patients who did not complete treatment, 18 (10%) because of side effects. Of 154 patients who completed treatment, 90 (58%) had their fissures healed and 105 (68%) were pain free. There was no difference in healing or symptoms between the 40- and the 80-day group. There was no predictor of fissure healing. A low fissure gravity score correlated with increased resolution of pain (P < 0.05) and improvement of VAS score (P < 0.05) on both univariate and multivariate analysis. A lower baseline resting pressure was associated with better pain resolution on univariate analysis (P < 0.01). VAS at defecation and fissure healing significantly improved until 40 days (P < 0.001), while the difference between 40 and 80 days was not significant.ConclusionWe found no benefits in treating CAF with topical GTN for 80 days compared to 40 days. Fissure healing and VAS improvement continue until 6 weeks of treatment but are unlikely thereafter.

Chronische und akute Analulzera

Classic types of anal ulcers are acute and chronic anal fissure. Characteristic symptoms of chronic fissures are severe pain during defecation accompanied by the triad of ulceration, hypertrophic anal papilla and external skin tag. If the symptoms deviate other causes of ulceration must be considered. Primarily, malignancies should be excluded. The special setting in the anal fold, especially with concurrent immunosuppression, could lead to nonspecific manifestations of different proctological, dermatological and infectious diseases, which can only be clarified by further diagnostic workup and histopathology. Only the correct diagnosis will lead to causal and effective therapy. Successfully treated inflammatory dermatoses and precancerous lesions require regular follow-up because a recurrent or persistent course of the disease may result in malignant transformation.

Obstructive ileus due to a giant fibroepithelial polyp of the anus

Fibroepithelial polyps or hypertrophied anal papillae are essentially skin tags that project up from the dentate line and the junction between the skin and the epithelial lining of the anus. They are usually small in size, but sometimes they become enlarged, causing unexpected medical conditions. An extremely rare case of a giant hypertrophied anal papilla complicated by obstructive ileus is reported. Fibroepithelial anal polyp, despite its size, should be included in the differential diagnosis of a smooth mass located near the anal verge, especially in a patient with a history of chronic anal irritation or infection.

A new species ofSyllis(Polychaeta: Syllidae: Syllinae) from off Fortaleza, north-eastern Brazil

In a study investigating the composition and spatial and temporal variation of the benthic macrofauna associated to the discharge of domestic sewage off Fortaleza, north-eastern Brazil, a new species ofSylliswas found. This new species,S. guidaesp. nov., is characterized by having blades of falcigers with subdistal tooth about same length as distal tooth, but stouter than it, with spines on cutting edge almost reaching the tip of subdistal tooth, blades of falcigers with conspicuous subdistal triangular process and unusually long anal papilla between anal cirri, measuring about one-quarter of their length.Syllis guidaesp. nov., is herein described and compared with the most similar congeners.

Three new solar-powered species of the genus Phyllodesmium Ehrenberg, 1831 (Mollusca: Nudibranchia: Aeolidioidea) from the tropical Indo-Pacific, with analysis of their photosynthetic activity and notes on biology

Three new Phyllodesmium species, Phyllodesmium lizardensis n. sp. from Lizard Island (Australia), P. lembehensis n. sp. from Sulawesi (Indonesia) and P. koehleri n. sp. from the Philippines, are described. Phyllodesmium lizardensis n. sp. and P. lembehensis n. sp. are associated with octocorals of the family Xeniidae and are similar to other Xeniidae-feeding Phyllodesmium species. Nevertheless, unique combinations of cerata morphology and colour, tooth and jaw morphology, the position of the anal papilla, as well as the special digestive glandular branching system within the cerata clearly distinguish these new species from described ones. Phyllodesmium koehleri n. sp. probably feeds on octocorals of the genera Lemnalia or Paralemnalia; it shows a cactus-like cerata morphology that is unique among Phyllodesmium species. In vivo measurements of photosynthetic activities in P. lizardensis n. sp. and P. lembehensis n. sp. indicate a symbiotic relationship with zooxanthellae at least for some days. These results are discussed in comparison to the Xeniidae-feeding species P. jakobsenae

Acute Anal Pain due to Ingested Bone Fragments

Impacted bone fragment in the anal canal must not be overlooked as an unusual cause of acute anal pain. Eight cases of acute anal pain arising from impaction of ingested bone fragment within the anal canal were treated over a 4-year period. The eight cases were similar in presentation and outcome. There were six males and two females (age 45∼65 years). Seven patients presented within a day of the sudden onset of severe anal pain, and one patient presented with obscure anal pain of three days. In two patients, this pain was aggravated by attempts to defecate. Inspection showed mild to marked spasm of the anal sphincter with no obvious cause for the anal pain. Digital rectal examination revealed spiculated bony fragments impacted in the anal canal at the dentate line in seven cases, and at the anorectal junction in one case. In one case, a fish bone was found penetrating into a hemorrhoid, causing edema and prolapse. In another case, a tiny fish bone was found impacting in a nylon seton applied to a fistulotomy wound. In a third case, a linear fish bone was found penetrating into an anal papilla. Six fish bones and one chicken bone were removed using forceps under proctoscopy. One fish bone was removed at the time of digital rectal examination. Sigmoidoscopy was then performed to assess anorectal injury. Pain relief was immediate, and no sequelae were noted on review at 6 weeks. In all cases, the diagnosis was readily made on simple digital rectal examination, and early removal of the bone fragment resulted in immediate pain relief without complications. Eight cases of acute anal pain due to impaction of ingested bone fragment in the anal canal are reported, and the related literature is reviewed.