. Diseases of the rectum and anus: designed for students and practitioners of medicine. opening, it bubbled out at more than a dozen difierent places. Pressure TREATMENT OF ANO-RECTAL FISTULA 271 in the rectum or at any point in the ano-gluteal region caused excruciatingpain, and forced out of the sinuses a rather thin, blood-stained discliarge. The patient was placed in the hospital and prepared in the usual wayfor the operatioHj which was as follows: One of the main sinuses was laidopen and curetted, and a search made for branch sinuses. These and theirbranches were treated in the same manne
. Diseases of the rectum and anus: designed for students and practitioners of medicine. opening, it bubbled out at more than a dozen difierent places. Pressure TREATMENT OF ANO-RECTAL FISTULA 271 in the rectum or at any point in the ano-gluteal region caused excruciatingpain, and forced out of the sinuses a rather thin, blood-stained discliarge. The patient was placed in the hospital and prepared in the usual wayfor the operatioHj which was as follows: One of the main sinuses was laidopen and curetted, and a search made for branch sinuses. These and theirbranches were treated in the same manner. Following out this general planthe operation proceeded until all of the sinuses, superficial and deep, weredivided except two which ran high up into the pelvis, and these, because ofthe danger of injuring the peritoneum, were curetted and cauterized. Duringthe operation it was necessary to divide the sphincter-muscle in three placesand remove large pieces of the undermined skin, leaving only that having asufficient blood-supply. Some idea of the extent of the raw surface left may. Fig. 90. -Appearance of Wounds Three Weel<s After Operation in Case ofMultiple Fistulas with Extensive Burrowing. be had from the accompanying photograph (Fig. 90), taken three weeks afterthe operation, when, as a result of healing, its size had diminished wound was irrigated daily and dressed with sterile gauze; the deepsinuses were packed loosely with gauze moistened with lO-per-cent. ichthyolsolution. The wounds healed nicely, and the patient had made a completerecovery, and was discharged from the hospital at the end of seven weeks. Case VII. Horseshoe Fistula.—Mr. L., aged 38 years, farmer, cameunder my care suffering from a fistula. He attributed its origin to an injury,received from a fall upon the frozen ground, that gave rise to an abscess whichpained him a great deal for several days. He applied poultices, the abscesspointed, and was lanced on the eighth day, and the pu
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
