It occasionally happens that in operating for the closure of a fecal fistula the surgeon encounters much difficulty, or even failure, in finding the aperture in the bowel. Especially is this likely to occur when the field of operation is a network of adhesions and the intestinal opening is obscured by blood. To illustrate such a difficulty and to suggest, if possible, a way out of it, I report the following case, in which the technic, so far as known, was original.
—In 1903, Miss J., aged 22, had a hysterectomy performed. During this operation the sigmoid flexure was injured, and, though the abdominal wound apparently healed, after a year there appeared a small opening in the lower end through which was discharged pus and fecal matter. This persisted for several months, with no tendency to close under the usual methods of treatment. In the latter part of 1904,
ROYSTER HA. LOCATING FISTULÆ IN THE LOWER INTESTINAL TRACT BY INJECTING HYDROGEN DIOXID THROUGH THE ANUS. JAMA. 1906;XLVII(2):111–112. doi:10.1001/jama.1906.25210020031003b
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