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November 1949

EXTERNAL ANORECTAL PROLAPSE IN CHILDREN DURING THE WAR YEARS

Author Affiliations

Surgeon, St. Canisius Hospital NIJMEGEN, NETHERLANDS

Am J Dis Child. 1949;78(5):671-676. doi:10.1001/archpedi.1949.02030050688003
Abstract

In NORMAL circumstances only occasional cases of external anorectal prolapse in children are seen, but during the war years there was a sharp increase in their number. The same observation was made in other countries.1

CAUSES  The anatomic predisposition of children for this disease is well known. The straight sacrum with the absence of a concave protecting excavatio rectococcygealis, the looseness and weakness of the connective tissues and sphincter and levator ani muscles around the rectum, the high position of the pelvic organs such as the bladder and uterus, with a deeply situated Douglas pouch, and the great mobility of the mesocolon, all play their parts. In several published reports of series of cases the majority was made up by girls and explained mainly on the basis of the aforementioned anatomic facts. In my series the majority was, however, formed by boys.Jeanel and Verneuil2 emphasized the importance

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