. Diseases of the rectum and anus: designed for students and practitioners of medicine. um willat once detect the trouble, except in those instances in whichthe deformity is situated very high or the rectum is entirelyobliterated. In cases where the diagnosis cannot be made bypercussion and palpation, celiotomy should be performedwithout delay. When congenital malformation is complicatedby fistula, the meconium, gas, and feces escape either with theurine, through the vagina, or upon the surface, through anexternal opening. CONGENITAL MALFORMATIONS 81 PROGNOSIS From what has aheady been said, i
. Diseases of the rectum and anus: designed for students and practitioners of medicine. um willat once detect the trouble, except in those instances in whichthe deformity is situated very high or the rectum is entirelyobliterated. In cases where the diagnosis cannot be made bypercussion and palpation, celiotomy should be performedwithout delay. When congenital malformation is complicatedby fistula, the meconium, gas, and feces escape either with theurine, through the vagina, or upon the surface, through anexternal opening. CONGENITAL MALFORMATIONS 81 PROGNOSIS From what has aheady been said, it is plain that theprognosis in congenital malformation of the rectum or theanus is good in some cases and unfavorable in others. Chil-dren suffering from narrowing of the anus or the rectum arequickly relieved by divulsion, and, when necessary, anus due to a membrane extending across theanal aperture is easily remedied, and seldom causes mortality is greatly increased, however, in cases wherethe inferior portion of the rectum is absent for one or more. Fig. 40.—Imperforate Rectum. The Anus Natural, but the Rectum is ObstructedSome Distance Above it by a Membranous Partition. inches. Here extensive cutting is necessary, and, as the newly-born child has little vitality, it often dies from shock. Whenthe rectum can be opened and united to the skin the prognosisis fair, but when this cannot be accomplished the dischargeescapes through an artificial channel unprotected by mucousmembrane and unsupported by muscular tissue. As a resultof this unnatural condition, annoying and dangerous compli-cations are to be expected immediately after the operation andalso later in life. The most distressing sequel is the formationof tight cicatricial strictures. It was these dangers which ledthe older surgeons to choose opening the bowel in the in- 83 DISEASES OF THE RECTUM AND ANUS guinal region rather than from below. Fistulous communica-tions between the bowel a
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
