Eisenhammer (1951) and Goligher, Leacock, and Brossy (1955) to be the spastic prominent lower edge of the internal

No abstract

Sphincter defects seen on ultrasound may not have a history of obstetric trauma or abnormal clinical and manometric findings. Endoanal ultrasound is recommended in all patients with fecal incontinence to detect occult sphincter defects.

This study examined the hypothesis that small bowel obstruction in patients whose only previous laparotomy was for appendicectomy or operation on the ovary or tube is unlikely to resolve with non-operative management. Results of 330 admissions for small bowel obstruction were examined. In 40 cases the only previous laparotomy was at appendicectomy or tubo-ovarian operation; in 38 (95 per cent) of these division of adhesions was undertaken compared with 154 (53 per cent) of the remaining 290 (P < 0.00001). In the former group band adhesions were commoner (86 versus 45 per cent, P < 0.00001), bowel resection was required more frequently (22 versus 10 per cent, P = 0.02) and it was considered safe to give a trial of non-operative management less often (60 versus 85 per cent, P = 0.0004). A trial of conservative management may be unsafe or not worth while in patients with obstruction following earlier appendicectomy or operation on the ovary or tube.

Although hartmann's procedure has been accepted by most as the treatment of choice for divenicular disease complicated by generalized peritonitis, restoration of continuity may be difficult. A restrospective review of 30 patients, having had hartmann's procedure for complicated divenicular disease, was made to assess restoration of continuity and factors which may influence its performance. This revealed zero mortality with a morbidity rate of 31.5% and a reversibility rate of 85% (with two cases still awaiting restoration of continuity).