. Diseases of the rectum and anus: designed for students and practitioners of medicine. is because anocular examination of the terminal rectum shows it to benormal. Sometimes the rectum ends in a blind sac, the lowerportion of which may be only a short distance or several inchesabove the anus. In rare instances the rectum and the sigmoidare entirely obliterated. Examples of the various types of congenital malforma-tions of the rectum and anus have been purposely who desire to study these manifestations in detail arereferred to Bodenhamers work. 78 DISEASES OF THE KECTUM AND ANU
. Diseases of the rectum and anus: designed for students and practitioners of medicine. is because anocular examination of the terminal rectum shows it to benormal. Sometimes the rectum ends in a blind sac, the lowerportion of which may be only a short distance or several inchesabove the anus. In rare instances the rectum and the sigmoidare entirely obliterated. Examples of the various types of congenital malforma-tions of the rectum and anus have been purposely who desire to study these manifestations in detail arereferred to Bodenhamers work. 78 DISEASES OF THE KECTUM AND ANUS SYMPTOMS Symptoms induced by congenital occlusion of the rectumor the anus may appear gradually or become urgent within afew hours after birth. Usually, children so afflicted live onlya few days; in exceptional cases, however, they have remainedin comparative comfort for several weeks. Shipman^ has re-corded the case of a child which lived more than three monthswithout discharging anything from the bowel. The majorityof these infants develop violent symptoms and die within forty-. Fig. 37.—Imperforate Anus, the Rectum Terminating in the Urethra. eight hours unless relieved by surgical intervention. The firstmanifestation observed is the absence of the stool, and conse-quently the retention of the meconium. Then follows theusual symptoms of intestinal obstruction: the little patientbecomes restless, feverish, cries most of the time, frequentlystrains to relieve the bowel, the abdomen grows tense, thepulse is weak and thread-like, the temperature irregular, res-piration difhcult, the face expresses suffering; then occursvomiting, first of the gastric and later of the intestinal con-tents, including meconium; the extremities become cold, and ^ Boston Medical and Surgical Journal, October, 1838. CONGENITAL MALFORMATIONS 79 death finally ensues from exhaustion and lack of nourishmentor from rupture of the intestine and collapse. The symptoms differ in the various types of congen
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