The rectum and anus : their diseases and treatment.

  • Charles Bent Ball
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: The rectum and anus : their diseases and treatment. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    Chap. XIII.] SpONTA NEO US R UPTUR E. I Q 7 position of the orifice of the prolapse is so altered when a hernia is present as to become a diagnostic sign. Ho says : Directly the bowel is protruded, you can tell that there is a hernia also present, by the fact that the opening of the gut is turned towards the sacrum. When the hernia is reduced, the orifice is immediately restored to its normal condition. The same changes which are observed in hern:a generally have also been noted in this form. It may become irreducible by the formation of adhesions between the sac and the con- tained viscera; or strangulation may result from the constriction of the neck by inflammatory swelling. According to Esmarch,* the formation of what he terms an anus preternaturalis in ano has been known to occur as a result of this strangulation. A very rare complication of complete prolapse is the spontaneous rupture of the entire rectal tunics, and the protrusion through the rent of a portion of the small intestine. In a very interesting paper by M. QuenUjt the whole subject of spontaneous rupture of the rectum is fully discussed, and the recorded cases of this rare injury collected. In all, nine cases have been noted; and of these, five are described tolerably completely, and in four of the five an old and extensive prolajosus recti preceded the rupture. The immediate exciting cause in these cases was some violent muscular effort, as defsecation, vomiting, or lifting a heavy weight; and in all the protrusion of small intestine through the anus was followed by a reduction of the prolapsus recti. All the cases occurred in adults, and but one was noted in the male subject, the others occurring in w^omen. In none of the cases did the structures appear to present any ma- croscopic change, such as ulceration or inflammatory * hoc. cit. t Des ruptures spontanees du rectiun,'' Revue de Chirurgie, Mar. 10,1882.