Operative surgery . Fig. 1201.—Absence of anus and lower part Fig. 1202.—Absence of anus and lower partof rectum, rectum opening into bladder. of rectum, rectum opening into urethra. infantile dimensions. The diameters between the important bony promi-nences which serve as guides are scarcely more than an inch in any Fig. 1203.—Absence of anus, lower part of Fig. 1204.—Absence of anus, rectum open-rectum communicating with glans penis. ing into vagina. The primanj indication of treatment is to establish an artificial anus, pref-erably in the inguinal region. 972 OPERATIVE SURGERY. T
Operative surgery . Fig. 1201.—Absence of anus and lower part Fig. 1202.—Absence of anus and lower partof rectum, rectum opening into bladder. of rectum, rectum opening into urethra. infantile dimensions. The diameters between the important bony promi-nences which serve as guides are scarcely more than an inch in any Fig. 1203.—Absence of anus, lower part of Fig. 1204.—Absence of anus, rectum open-rectum communicating with glans penis. ing into vagina. The primanj indication of treatment is to establish an artificial anus, pref-erably in the inguinal region. 972 OPERATIVE SURGERY. TJie Operation.—With the patient in the exaggerated lithotomy position(Fig. 1195), introduce the finger into the rectum, note the seat and extentof the septum, and make incisions into it, radiating from the center; evacu-ate the contents of the gut, trim off the flaps, and maintain the o})euing bythe occasional introduction of a well-oiled bougie. 8ometimes the occlu-sion is so thick as to raise the question of the presence or absence of the gutabove. The sigmoid flexure may terminate in a blind point, while the rec-tum below is marked by an impervious cord (Fig. IIGT). An attempt shouldalways be made to find the blind extremity, which is practiced by intro-ducing a sound into the bladder andcarefully seeking, by a
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