. Diseases of the rectum and anus: designed for students and practitioners of medicine. eand below (Plate XX). On post-mortem examination, a sec-tion of the stricture (Fig. 110) will, in most instances, creakwhen pressed between the fingers, be firm to the touch, ofglistening appearance, like other scar-tissue, and ofifer much 358 DISEASES OF THE RECTUM AND ANUS resistance to the knife. There will be found an abundant in-crease of connective tissue at the seat of the stricture and inits immediate vicinity; all of the rectal coats and the tissuesbeneath them and in the ischio-rectal fossae will
. Diseases of the rectum and anus: designed for students and practitioners of medicine. eand below (Plate XX). On post-mortem examination, a sec-tion of the stricture (Fig. 110) will, in most instances, creakwhen pressed between the fingers, be firm to the touch, ofglistening appearance, like other scar-tissue, and ofifer much 358 DISEASES OF THE RECTUM AND ANUS resistance to the knife. There will be found an abundant in-crease of connective tissue at the seat of the stricture and inits immediate vicinity; all of the rectal coats and the tissuesbeneath them and in the ischio-rectal fossae will be found in-durated and fixed. In cases of long standing ulceration andirregular nodules can be felt above and below the stricturedpoint (Plate XX). Dilatation of the rectum above the con-striction always takes place,—due largely to fecal impaction,—while narrowing is the rule below the stricture. Fistula is afrequent complication, and acts as a sewer to carry off thedischarge from the ulcerations. A fistula opens more fre-quently above than below the stricture. Around the anal. Fig. 110.—Appearance of a Cross-section of Strictured Rectum. margin and lower part of the rectum there are often vege-tations, piles, and tags of skin, which are indicative of achronic discharge. When the fistula becomes stopped up orthe submucous tissue becomes infected from the poisonousdischarges, an abscess will result. This abscess may open intothe bladder, the vagina, or upon the surface of the the intestines will be bound together by bands ofadhesions the result of chronic peritonitis. In one fatal case,where the writer succeeded in getting a post-mortem examina-tion, the intestines were found matted together and coveredwith pus. SYMPTOMS The symptoms of rectal stricture must necessarily be bothlocal and general. The former are due to ulceration. Thelatter are caused by mechanic obstruction of the alimentary NON-MALIGNANT STRICTURE 359 canal; such an obstruction creates a
Size: 1356px × 1843px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
