The patient, known as the
"balloon-man," aged twenty-three at the time of his death, had
had a distended abdomen from infancy. Postmortem the colon was
found as large as that of an ox, the circumference ranging from
15 to 30 inches. The weight of the contents was 47 pounds. Cases
are not uncommon in children. Osler reports three well-marked
cases under his care. Chapman mentions a case in which the liver
was displaced by dilatation of the sigmoid flexure. Mya reports
two cases of congenital dilatation and hypertrophy of the colon
(megacolon congenito). Hirsohsprung, Genersich, Faralli, Walker,
and Griffiths all record similar instances, and in all these
cases the clinical features were obstinate constipation and
marked meteorismus.
Imperforate Anus.--Cases in which the anus is imperforate or the
rectum ends in a blind pouch are occasionally seen. In some
instances the rectum is entirely absent, the colon being the
termination of the intestinal tract. There are cases on record in
which the rectum communicated with the anus solely by a
fibromuscular cord. Anorectal atresia is the ordinary
imperforation of the anus, in which the rectum terminates in the
middle of the sacral cavity. The rectum may be deficient from the
superior third of the sacrum, and in this position is quite
inaccessible for operation.
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