Identifier: referencehandboo02buck (find matches)
Title: A reference handbook of the medical sciences, embracing the entire range of scientific and practical medicine and allied science
Year: 1913 (1910s)
Authors: Buck, Albert H. (Albert Henry), 1842-1922 Stedman, Thomas Lathrop, 1853-1938
Subjects: Dictionaries, Medical
Publisher: New York : W. Wood and Company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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lj com-niuuicate with each other, or, in extreme cases, formtogether a large pouch (cloaca) into which the intestineand ureters open. TIls condition of things may be as-sociated with imperforate anus. Entire absence ofthe bladder has been reported, in which case the ure-ters opened directh into the urethra. Exstrophy.—The most common fault of development, however^ is the absence of the anterior vesica If the fault of development is not so e.vtensivo as incomplete exstrophy, the abdominal walls may uniteentirelj- up to the umbilicus, which fails to close andleaves a fistulous communication with the bladderthrough the still patent urachus. An even lesserdegree of the same deformitj- is represented by a pro-longation of the bladder up into tne lower portion ofthe urachus. Sometimes the canal may be shut offfrom the bladder and form a cyst, or a series of cysts. The suflfering in a case of complete exstrophy isusually very great. The treatment maj be briefly summarized underthree heads:
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Fig, 651.—Ex-strophy of Bladder in a Girl of Sixteen Years.Complete exstrophy. Pubic rami are separated four inches, theposition of the ends being approximately shown by the pubic hair.Above is the bulging posterior bladder wall, while below, thethickened hypertrophied cen-ix protrudes from the vulva. (Ca-seof Dr M. H. Richardson ) wall. This deformity, known as exstrophy of thebladder, is far more common in males than in females.It consists in a failure of union of the two halves ofthe body along the abdominal .surface. The anteriorwall of the bladder, and the abdominal wall over it.are wanting, and the pubic bones are generally .sepa-rated by a considerable interval. The posterior vesi-cal wall is consequently exposed to the air, and ispressed forward by the intestines behind it, thus form-ing a prominent tumor which maj- reach the size of thepalm of the hand. This bulging bladder wall, owingto the constant irritation to which it is subiected, ismuch reddened and inflamed, and is

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