Diseases of the rectum and anus / by Alfred Cooper and F. Swinford Edwards.

  • Cooper, Alfred, Sir, 1846-1908.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the rectum and anus / by Alfred Cooper and F. Swinford Edwards. Source: Wellcome Collection.

    72/388 (page 46)
    known to occur. If neglected, the occlusion will result in increasing distension of the abdomen, Yomiting of meconium, and ultimately collapse and death. In rare cases the anus is only partially closed by membrane. The treatment consists in making a free incision through the membrane, exactly in the middle line. In cases in which the septum is very thick and the impulse indistinct, it is well, as a preliminary, to make an exploratory puncture with a grooved needle. If no meconium escaj)e, the case will belong to another category, to be subsequently described. If the bowel has been reached, and its contents can freely escape, it is unnecessary to use tents or bougies to keep the orifice dilated. The occasional passage of the finger through the anus will prove sufficient. In all cases of this kind the external sphincter is usually well developed, and hence, as time goes on, there is no difficulty in retaining the fseces. Even if the external sphincter were absent, its function would, at least in great measure, be performed by the circular fibres of the bowel. When there is a deficiency of the lower part of the rectum, and the latter is found at a slight depth below the skin, it is well to draw down the walls of the gut, and by means of sutures to attach the mucous mem- brane to the margin of the incision. The operation will be described in the treatment of the succeeding form. 3. Entire Absence of Anus, the Rectum ending in a blind Pouch at a varying distance from the Perinseum (Figs. 6 and 7).—This class contains some of the most difficult and serious cases. In place of the anal orifice, the integument is found to l3e continuous from behind forwards and from side to side; presenting in some cases a slight circular