. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. Fig. 40.—Imperforate Anus [Esynarch). membrane across the anus, through which the dark shade ofthe meconium shows. In other instances the anus and lower 110 MALFOliMATIONS OF THK RKCTUM-FRVRITIS . Ill rectum is perfect, liut there is a septum higlier up. Inother cases the wliole rectum is wanting, and even someportion of tlie colon. There are also instances where therectum ends in the vagina or in the bladder. Treatment.—Where there is onlv a thin meml)rHne. Fio. 41.—Impeefoeate Rectum (Esniar
. Rectal and anal surgery : with description of the secret methods of the itinerant specialists. Fig. 40.—Imperforate Anus [Esynarch). membrane across the anus, through which the dark shade ofthe meconium shows. In other instances the anus and lower 110 MALFOliMATIONS OF THK RKCTUM-FRVRITIS . Ill rectum is perfect, liut there is a septum higlier up. Inother cases the wliole rectum is wanting, and even someportion of tlie colon. There are also instances where therectum ends in the vagina or in the bladder. Treatment.—Where there is onlv a thin meml)rHne. Fio. 41.—Impeefoeate Rectum (Esniarcli). closing the anus, it is easy to divide it l>_v a crucial incision,and cure the patient. If the rectum stops higher up, then we are in doubt asto where the ciil de snc is to be found. It is propei-, how-ever, to seek for it. The patient being , anincision is made from the center of the spot where the anusshould be, directly back to the tip of the coccyx. If thecul de sac of the gut is there at all it will be in or ])el()w 112 RECTAL AND ANAL SURGERY. the hollow of the sacrum. The incision is therefore cautiouslymade on the middle line, close to the sacrum, and. if needful,the coccyx may be excised to enable the o[)erator to gethigher up. The gut is felt for with the finger, and if foundis opened, and if possible chawn down and stitched to theincision as near to the normal location of the anus as itsextensibility will permit without much tension. In thisblind search one feels very uneasy as he goes deeper. Ifchild has been liorn
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Keywords: ., bookcentury1800, bookdecade1880, booksub, booksubjectanusdiseases
