The rectum and anus; their diseases and treatment

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1895 Excerpt: ...as an ordinary prolapsus recti, which gradually increased in dimensions by successive portions of the colon becoming involved, until the whole protruded. A similar result has been known to follow from an ileo-caecal intussusception, the large intestine becoming invaginated from above downwards. In this latter case the first part to appear through the anus will be the ileo-caecal valve, while in the former it will make its appearance last. In cases of colic or rectal intussusception, which have secondarily involved the entire lower portion of great intestine down to the anus, it may be impossible to arrive at a conclusion as to whether the disease has originated as an ordinary prolapse, or as an intussusception higher up. The mass may also assume large proportions, even to the extent of hanging down between the thighs. (See Fig. 27.) This may be the case to such a degree that all attempts to return it within the abdominal cavity will prove abortive. Prolapsus recti is generally unattended with any very severe pain, the mucous membrane, from a point immediately within the anal margin, being of low sensibility; but the constant mucous discharge, and the incontinence of faeces, which in severe cases is always more or less present, render the patient very miserable. The complications of complete prolapse are both important and serious; and they owe their chief gravity to the involvement of a peritoneal pouch brought down with the prolapse. In intussusception, the invaginated peritonaeum is usually soon the seat of a localised adhesive peritonitis, which obliterates the sac; but this is not the case in prolapsus recti, the protruded portion of peritonaeum retaining its continuity with the general cavity. Into this peritoneal pouch a portion of intestine is apt to...