On a case of high excision of the rectum : the section of the bowel being above the reflection of peritoneum, with recovery / by Frederick S. Eve ; introducted by Stephen Mackenzie.
- Eve, Frederick Samuel, Sir, 1853-1916.
- Date:
- [1887]
Licence: Public Domain Mark
Credit: On a case of high excision of the rectum : the section of the bowel being above the reflection of peritoneum, with recovery / by Frederick S. Eve ; introducted by Stephen Mackenzie. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![Seprinted from Vol. XX of the ' Clinical Society's Transaction*.''] On a Case of High Excision of the Rectum ; the Section of the Bowel being above the Reflection of Peritoneum., ivithrecovery. By Frederic S. Eve. In- troduced by Dr. Stephen Mackenzie. Read March 11, 1887. ELIZA P., £et. 34, was admitted to the London Hospital with cancer of the rectum. The symptoms began nine months before, when she complained of severe pain in the rectum and frequency of defaecation with diarrhoea. She had passed blood for three months. During the last few weeks she had only passed one motion daily. Condition of rectum.—The anus was unaffected. Above it the rectum was involved throughout its whole circumference by an ulcerated cancerous growth. While the patient was under an anaesthetic the finger could appai-ently be passed above the growth, and Mr. Treves, who had previously examined the case, was of the same opinion as myself. The rectum was not adherent to the vagina nor at any other point. Operation on August 3. — The operation was performed in the usual manner, an incision having first been made down to the coccyx. After separating the rectum from its surround- ings as high as was deemed advisable it was found that the upper limit of the growth had not been reached. The opera- tion was continued and the peritoneal cavity opened anteriorly. The entire circumference of the reflection of peritoneum upon the rectum was severed partly by tearing and by touching resisting points with the thermo-cautery. After its complete division the rectum, which had previously resisted traction, could readily be drawn down. The diseased portion was re- moved with a wire ecraseur. Haemorrhage was slight. The portion of bowel removed measured six inches in length and the line of section was at least half an inch above the upper limit of the disease. After thoroughly cleansing the cavity of the wound the bowel was secured to the anal margin by two or three sutures, and a large drainage-tube was passed into the cavity of the sacrum. Not the slightest traction was neces- sary in bringing down the bowel. Intestine was seen, but there was no tendency to protrusion. Iodoform with wood- wool pads were used as dressing. The constitutional disturb- ance after the operation was exceedingly slight and there was at no time any evidence of peritonitis. The temperature did](https://iiif.wellcomecollection.org/image/b22300120_0005.jp2/full/800%2C/0/default.jpg)
