. Diseases of the rectum and anus: designed for students and practitioners of medicine. se of the frequent stretching by the protruded mass,the sphincter-muscle, in the majority of cases, loses its tonicity,and becomes relaxed or totally paralyzed. Before this condi-tion is brought about, however, the sphincter, as a result ofirritation, sometimes contracts around the bowel, preventing areturn of blood and eventuating in sloughing of the projectedbowel. In cases where the bowel returns spontaneously or re-mains above the muscle when replaced by the mother or anattendant, about the only change
. Diseases of the rectum and anus: designed for students and practitioners of medicine. se of the frequent stretching by the protruded mass,the sphincter-muscle, in the majority of cases, loses its tonicity,and becomes relaxed or totally paralyzed. Before this condi-tion is brought about, however, the sphincter, as a result ofirritation, sometimes contracts around the bowel, preventing areturn of blood and eventuating in sloughing of the projectedbowel. In cases where the bowel returns spontaneously or re-mains above the muscle when replaced by the mother or anattendant, about the only change noticeable in its appearanceis a slight redness and erosion of the mucous membrane. PROLAPSE 385 CLASSIFICATION There are many and varying degrees of procidentia recti,but for clinic purposes it may be considered as occurring inthree degrees:— 1. Prolapse of the mucous membrane alone. 2. Prolapse of all the rectal coats and sometimes includ-ing a part of the smaH intestine (hernia recti). 3. Prolapse of the colon, sigmoid, or upper rectum intothe lower rectum, called Fig. 124.—Typic Case of Extensive Complete Procidentia Recti in BoyThree Years Old (Congenital). Prolapse of the Mucous Membrane (Partial Procidentia).—This is the most common form of prolapse. It is usually metwith in children between one and five years of age, sufferingfrom summer diarrhea, whooping-cough, phimosis, or difficultmicturition. It comes on suddenly after a strain as the resultof detachment of the mucous membrane from its bed, whichpermits it to slide down and out at the anus (Figs. 122 and 123). The protrusion is usually small, being about one or twoinches ( or centimeters) in length, highly colored, andreturns either spontaneously or by the aid of slight the exciting cause is removed, repeated protrusions, 25 386 DISEASES OF THE RECTUM AND ANUS becoming more extensive as the child grows older, are to beexpected. Prolapse of All the Rectal Coats (Complete
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
