Accidental Transanal Perforation of the Rectum

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Abstract
Over the past few years three cases of transanal perforation of the rectum in childhood have been brought to our attention. Two of these cases succumbed, with the lack of diagnosis both before and during surgery of prime importance. So obscure were the sites of perforation (even at autopsy) in all of these cases that it seemed expedient to emphasize this type accident and to suggest diagnostic maneuvers that might prove helpful during an otherwise frustrating exploratory operation. Report of Cases* Case1.—Two-day-old girl. Admitted Aug. 13, 1953; died Aug. 14, 1953. History: At end of a normal first day of life this 2270-gm. (5-lb.) baby was found in "shock," with evidence of bilious vomiting. Meconium stools had been passed. Physical examination revealed a critically ill cyanotic infant with a distended quiet abdomen. X-rays showed air under the diaphragm. Treatment: I. V. and antibiotic therapy was followed by an unrewarding

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