. American practice of surgery ; a complete system of the science and art of surgery . ctum from any cause {, a stricture, the pressure exerted from without by SURGICAL DISEASES OF THE AXUS AXD RECTUM. 879 a malignant ijrowth, will intiTtt^re with the free passage of fecal matterand will tend to ilrag down first the mucous and then the other coats of thebowel and thus produce a prolapse of the third degree. Such a prolajDse is fre-quently found associated with an abnormally elongated meso-signioid or meso-rectuni. Thi ulcerations which are so frecjuently associated with this form ofp
. American practice of surgery ; a complete system of the science and art of surgery . ctum from any cause {, a stricture, the pressure exerted from without by SURGICAL DISEASES OF THE AXUS AXD RECTUM. 879 a malignant ijrowth, will intiTtt^re with the free passage of fecal matterand will tend to ilrag down first the mucous and then the other coats of thebowel and thus produce a prolapse of the third degree. Such a prolajDse is fre-quently found associated with an abnormally elongated meso-signioid or meso-rectuni. Thi ulcerations which are so frecjuently associated with this form ofprolapse in its chronic stage, are probably the result, and not the cause, of theaffection; they are undoubtedly produced ])y the friction of the bowel as itslips up and down. The extent of the prolapse varies greatly, and in fact is onh- limited by thelength of the colon: but ordinarily it measures from three to six inches in length. :\is.—In both the complete and the incomplete types the symptomsare practically the same. At first, the protrusion occurs only at stool, Fig. 363.—Drawing Illustrates a Case of Complete Procidentia of the Rectum; Second Degree. and Tuttle.) (Earle later on, when the sphincters become more relaxed and the attaelmientsstretched, it may occur upon the slightest provocation, as from standing orwalldng: or, in old people, in whom there is atony of the sphincters, the pro-lapsed bowel may remain down whene^er the patient is on his feet. Consti-pation is the iTde with these patients, until the mucous membrane of the rec-tum becomes excoriated or inflamed, when a teasing diarrhoea follows, whichmay eventually result in partial incontinence, on account of the blunting ofsensibility that takes place. The one characteristic and pei-sistent sjTuptom. is the protnision. Theonly conditions with which it is at all likely to be confounded are hemoiThoidsand a protruding neoplasm, from both of which it can be readily differentiatedb} the circular f
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
