. Diseases of the rectum and anus: designed for students and practitioners of medicine. e internal open-ing is situated posteriorly at the junction of the external andinternal sphincters, though in not a few cases it is located oneither side higher up. The external opening is ordinarily tobe seen within an inch ( centimeters) of the anus, and inmany cases just opposite the internal opening. Again, theexternal opening may be quite a distance from the anus (), and the sinus leading from the external to the internal ANORECTAL FISTULA 239 opening may be very long and irregular (Fig. 61)
. Diseases of the rectum and anus: designed for students and practitioners of medicine. e internal open-ing is situated posteriorly at the junction of the external andinternal sphincters, though in not a few cases it is located oneither side higher up. The external opening is ordinarily tobe seen within an inch ( centimeters) of the anus, and inmany cases just opposite the internal opening. Again, theexternal opening may be quite a distance from the anus (), and the sinus leading from the external to the internal ANORECTAL FISTULA 239 opening may be very long and irregular (Fig. 61) and havediverticula leading from it in various directions. This formof fistula constitutes about 75 per cent, of the cases. Blind Internal Fistula consists of a sinus without an externalcommunication, but with an internal opening into the rectum(Fig. 59, B). While not so common as the complete variety,one who treats rectal disease as a specialty will meet manysuch cases, and will find them, in many instances, very difficultto diagnosticate. The sinus may have its origin at any point. Pig. 67.—Horseshoe Fistula. in the ischio-rectal fossa, in the submucous or subcutaneoustissues, and its course may be in any direction (Figs. 59, 62,and 63). Blind External Fistula is superficial, and usually formed froman abscess located in the subcutaneous tissues, the pus fromwhich has found an outlet only upon the surface of the is no communication with the rectum at all (Fig. 64, A),though it burrows in that direction if not operated upon. Thisform of fistula is very rare, being less frequent than the blind 340 DISEASES OF THE RECTUM AND ANUS internal variety. In rare instances a blind external fistula maybe the remains of a complete fistula the rectal opening of whichhas closed spontaneously. Complete Internal Fistula (Fig. 64, B) is seldom met consists of a sinus with two openings, both into the rectum,and is very difficult to diagnosticate, but easily cured whenfound.
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
