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June 23, 1945


JAMA. 1945;128(8):559-563. doi:10.1001/jama.1945.02860250005002

At a previous meeting of this section I1 discussed the operative injury of the anal sphincter. The present topic is a sort of sequel and is also apropos to current emphasis on traumatic surgery. The intraperitoneal complications of rectal injuries and concomitant damage to neighboring organs such as the bladder have been primarily stressed heretofore and rather fully reported (as their seriousness deserves) and hence will not concern us here.

On the other hand there is little to be found concerning the perineal issues alone and particularly their own essential significance in relation to devastating and even fatal sequelae. I do not have in mind the occasional unfortuitous complications of surgery in general but consequences inexorably determined by the surgeon's deliberate plan of operation and under his responsible control. These considerations not only pertain to traumatic injuries but comprise basic proctologic principles which even in their more obvious connections