. Diseases of the rectum and anus: designed for students and practitioners of medicine. o occur as a sequel of irritation or slight bruising ofthe parts, owing to the ever-present bacteria, lowered resist-ance, and faulty blood-supply of the perirectal connective cysts (page 491) situated over the sacrum and coccyxare responsible for the majority of fistulas opening above 238 DISEASES OF THE EECTUM AND ANUS the anus in the posterior median Hne. Tuberculosis, beginningin the rectum or upon the skin, is a frequent cause of fistulain the ano-rectal region. Some authors contend that
. Diseases of the rectum and anus: designed for students and practitioners of medicine. o occur as a sequel of irritation or slight bruising ofthe parts, owing to the ever-present bacteria, lowered resist-ance, and faulty blood-supply of the perirectal connective cysts (page 491) situated over the sacrum and coccyxare responsible for the majority of fistulas opening above 238 DISEASES OF THE EECTUM AND ANUS the anus in the posterior median Hne. Tuberculosis, beginningin the rectum or upon the skin, is a frequent cause of fistulain the ano-rectal region. Some authors contend that theformation of a sinus in these cases is not always precededby abscess: views not in harmony with those of the writer. VARIETIES OF FISTULA There are several varieties of fistula named from theirlocation, number of openings, and the organs with which theycommunicate, as follows:— 1. Complete. 6. Horseshoe. 2. Blind internal. Y. Complex. 3. Blind external. 8. Recto-vaginal. 4. Complete internal. 9. Recto-vesical. 5. Complete external. 10. Recto-urethral 11. Recto-labial (vulvar).. Fig. 66.—Complex Horseshoe Fistula witli Six Openings on the Surface, Onein the Rectum, One in the Vagina, and Two in the Labia. Complete Fistula is one which has two openings: one uponthe surface of the body in the neighborhood of the anus andthe other in the rectum (Fig. 59, A; and Plate XVI). Itis the most common form of fistula. The openings of com-plete fistula vary as to location. As a rule, the internal open-ing is situated posteriorly at the junction of the external andinternal sphincters, though in not a few cases it is located oneither side higher up. The external opening is ordinarily tobe seen within an inch ( centimeters) of the anus, and inmany cases just opposite the internal opening. Again, theexternal opening may be quite a distance from the anus (), and the sinus leading from the external to the internal ANORECTAL FISTULA 239 opening may be very long and irregular (Fig
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
