Generality
In anatomy, anastomosis is defined as a link between two organs, blood vessels, nerves, connective fibers or myocardial fibers.
In other circumstances, an anastomosis can be abnormal or pathological (as happens, for example, in the case of patent foramen ovale or in arteriovenous fistulas).
Another distinction that can be made when talking about anastomosis is that in a natural anastomosis (physiological or pathological) and surgical or artificial anastomosis.
Below, these different types of anastomoses will be briefly described.
Physiological anastomoses
Physiological anastomoses are naturally present within the body and do not cause damage; indeed, they are indispensable for allowing the communication of districts or bodies that would otherwise be isolated from one another.
Among these, the best known are, most likely, the anastomoses present in the circulatory system. In fact, there are many anastomoses naturally present both in arterial and venous vessels.
The task of the anastomosis of the blood vessels is to ensure blood circulation even in the case of stenosis or occlusion of the large vessels from which the anastomoses themselves arise. Therefore, these links can be considered a kind of natural by-pass.
Not by chance, arterial anastomoses are particularly numerous in the abdominal organs, at the coronary level and in the articular areas.
Pathological anastomoses
Pathological anastomoses - as can easily be deduced from their own name - are unions and pathological connections that form between organs, blood vessels, or between internal cavities and the skin; as a rule, these anastomoses should not be present and their formation causes damage to the organism.
To indicate different types of pathological anastomoses, the term "fistulas" is preferentially used. The latter, in fact, are defined as anomalous canaliculi that connect different adjacent anatomical districts which, in physiological conditions, should be separated from each other.
Among the different types of pathological anastomoses most known, we recall:
- Anorectal fistulas;
- Rectovaginal fistulas;
- Ureterovaginal fistulas;
- Bladder-vaginal fistulas;
- Bladder-cervical fistulas;
- Bronchoesophageal fistulas;
- Fistulas of the digestive system;
- Dental fistulas.
Of course, the type and severity of symptoms that can occur following the formation of these fistulas depend on the type of pathological anastomosis that has arisen, just as the therapeutic strategy that one decides to undertake will depend on the cause causing the anastomosis, from its severity and from the affected anatomical districts.
However, for more detailed information on this subject, we recommend reading the dedicated article already on this site "Fistula: symptoms, complications and therapy".
Surgical Anastomosis
The surgical anastomosis is a particular type of anastomosis that is artificially produced by the doctor during the execution of a special surgical intervention; for this reason, it is also called artificial anastomosis .
Generally, surgical anastomoses are performed to connect hollow organs, such as blood vessels, intestines, bronchi, ureters, etc.
The surgical anastomosis is generally used to join two hollow organs or parts of the same, in order to resume the normal functionality - previously interrupted - of that same organ.
Surgical anastomoses can be performed by the doctor in different ways and with different techniques, depending on the anatomical districts that he intends to put into communication and according to the purpose he aims to achieve.
In this regard, we can distinguish:
- Termino -terminal anastomosis, in which the terminal portions of the two organs or districts that are to be joined are sutured directly one to the other, in a continuous manner.
- Latero-lateral anastomosis, in which the walls of the two hollow organs or the portions of the same organ are placed side by side and sutured, precisely, laterally to one another.
- Termino-lateral anastomosis, in which the terminal part of an organ or body district is sutured with the lateral part of the same or of another body or body district.
- Latero-terminal anastomosis, in which, instead, the suture is carried out between the lateral part of an organ or body district and the terminal portion of the other.
Among the different types of surgical anastomoses that can be performed, we recall the ileo-anal anastomosis, performed to connect the ileum and anus (for more detailed information on this, see the article "Ileostomia") and the gastro-enteric anastomosis, performed to connect the stomach to the intestine (eg gastric bypass for obese or gastro-entero-anastomotic individuals in the case of gastric tumors).
