. Diseases of the rectum and anus: designed for students and practitioners of medicine. probe, and whennear the anus can be easily seen, especially if it is due to afold of skin stretching partially over the anal aperture. When the occlusion is complete and induced by a mem-brane, a correct diagnosis can readily be reached from thebulging caused by pressure of retained meconium upon thebowel when the child cries or cousfhs. In those cases where 80 DISEASES OF THE EECTUM AND ANUS the anus is absent and the rectum ends in a sac, much in-genuity is required to determine the exact condition, becau
. Diseases of the rectum and anus: designed for students and practitioners of medicine. probe, and whennear the anus can be easily seen, especially if it is due to afold of skin stretching partially over the anal aperture. When the occlusion is complete and induced by a mem-brane, a correct diagnosis can readily be reached from thebulging caused by pressure of retained meconium upon thebowel when the child cries or cousfhs. In those cases where 80 DISEASES OF THE EECTUM AND ANUS the anus is absent and the rectum ends in a sac, much in-genuity is required to determine the exact condition, becausethere are no external manifestations to serve as a guide. Muchinformation is to be obtained by pressing the abdominal con-tents downward with one hand while the perineum is palpatedwith the other to ascertain whether the distended rectum canbe reached. When the perineum and the end of the rectalpouch are more than one inch ( centimeters) apart, no im-pulse can be felt; when the distance is less, it can usually bedetected. Where obstruction is dependent upon an imperforate rec-. Fig. 39.—Imperforate Anus, the Rectum Opening on the Surface by Means ofa Fistulous Sinus through the Penis. turn due to occlusion of the bowel by a membranous partitionor a bhnd end, the real trouble is frequently unsuspected untilthe patient is beyond help, because the anus is natural in ap-pearance. The little finger introduced into the rectum 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 malforma
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
