Gastrointestinal Pathology: Large Intestine: Imperforate Anus: Congenital Atresia of the Rectum

Aubrey T.L., aged 4.5 months, was admitted under Mr Lane for obstruction. The child was born with an imperforate anus due to a septum about an inch above the anus; this was punctured by means of dressing forceps on the fourth day after birth and faeces were passed normally until the fourteenth, when obstruction recurred and dilation was again resorted to. The parents were instructed to pass a bougie regularly, but neglected to do so and the faeces gradually accumulated until, on admission, the lower part of the abdomen was filled with a large dough-like tumour formed by the distended rectum. Colostomy failed to empty the bowel, and two days after, the septum, which had reformed, was cut away but death occurred the same evening. At the autopsy the dilation of the gut was found to have extended as high as the splenic flexure, the intestine above this level being quite small.