The incidence of fistula-in-ano following anorectal abscesses was studied prospectively in 50 consecutive patients. A total of 13 patients (26 per cent; 95 per cent confidence limits: 14-40) had a fistula diagnosed either in the acute phase or during follow-up within 6 months. Half of the fistulas diagnosed at follow-up were unrecognized by the patients and no fistulas developed in patients where culture from the abscess only revealed skin-derived bacterias. X-ray examination was of no value in the diagnosis of anal fistula.

The rate of yersiniosis in patients with acute abdominal disease was studied in a 16-month prospective investigation in 1972-1973 of 205 acutely ill patients referred to a surgical clinic of a Copenhagen City hospital with complaints of abdominal pain suggestive of appendicitis. Yersinia enterocolitica, biotype 4, was isolated from 11 patients (5.4%), 8 of whom were children. Yersinia was grown from faeces in 8 cases and from appendix of all 9 patients operated upon. Rising or falling agglutinin titres larger than or equal to 100, indicative of yersiniosis, were found in 22 patients (10.7%) including all bacteriologically verified cases. Eight additional patients (3.9%) had less significant titres larger than or equal to 100, suggestive of recent or present infection. 28 patients (13.7%) had insignificant titres, including 3 with antibodies against serotype 9. In all cases except these 3, antibodies were against Y. enterocolitica, serotype 3. A differential diagnosis between Y. enterocolitica infection and other types of appendicitis could not be made within this highly selected group of patients using available clinical data. All cases were rather mild and self-limiting. It is suggested that in future epidemiological and other studies of yersiniosis, early bacteriological and serological examinations be carried out.

Cineradiographic defaecography combined with measurement of the anorectal angle and descent of the pelvic floor is proposed. The method used in 73 women gave valuable information in 48 patients who complained of anal incompetence, rectal tenesmus, and chronic constipation. In these patients, high and low rectal intussusception, rectocele, and pathologic movement of the pelvic floor were detected. Some of these phenomena could only be diagnosed by the radiologic method here described. Quantitations of the anorectal angle and descent of the pelvic floor placed the group with constipation halfway between normal individuals and those with anal incompetence. The value of this finding is discussed. Recent improvements in anorectal surgery often make videodefaecography decisive for the choice of the optimal operative method. Therefore, videodefaecography together with measurement of the anorectal angle and pelvic floor descent is recommended whenever anorectal surgery for correction of functional disturbances is contemplated.Since the pioneer work of BRODEN & SNELLMAN in 1968 (4), cinedefaecography has only been sporadically mentioned in the literature (1, 5-7). However, during the past few years, anal incompetence has become a less concealed complaint in the female population. The fact that more patients demand help, and the refinement of therapeutic options, make cinedefaecography an important method to reveal abnormalities in the pelvic floor. Dysfunction in the anorectal region of psychologic origin cannot always be excluded (10, II).Since methods for objective diagnostic procedures are indicated, to improve cinedefaecography, we combined real-time videotape recordings with quantitative measurements of the anorectal angle (ARA) and descent of the pelvic floor (D). Material and MethodsVideodefaecography was performed in 73 women with a mean age of 55 years (range 26-82, evenly distributed). Twenty-five women were asymptomatic volunteers with a mean age of 53 years (range 28-78). Of the other 48 women, 25 had anal incompetence, 2 had flatus incompetence, 2 rectal tenesmus, 15 chronic constipation, and 4 patients had different complaints and were examined twice.The patients were prepared in the same way as for barium examination of the colon. Approximately 200 ml of thick barium contrast medium (a mixture of half-volume Mixobar oesophagus and half-volume Mixobar suspension) was instilled through a catheter into the rectum. At the end of instillation, the catheter was carefully withdrawn in order to mark the anal canal with contrast medium. The patient was then placed in a standardized pot chair in front of a fluoroscopic unit, with the lateral view of the rectum positioned in the centre of the field. Fluoroscopy was registered on videotape during rest and evacuation. The fluoroscopic position was held static during the whole procedure. Both the rectum, the anal canal, and the upper edge of the pot chair had to be visible on the TV simultaneously.From the video sequence, static images were acquired during rest and under...