Roentgen Appearances in Mechanical Rectal Constipation

i n a Elcengren and B j o r n S n e l l m a nApart from cases such as a tumour, sigmoiditis, volvulus, megacolon &c. the roentgen appearances in constipation have not yet been studied sufficiently to yield information of much practical value.The investigations of WALLDGN and SNELLMAN have brought to light previously unsuspected causes of intractable constipation.The present paper is intended to give a preliminary report of our experiences in this field, especially from the aspect of the radiologic diagnosis.Among patients seeking medical attention for constipation there is one group in which certain symptoms are consistently mentioned in response to detailed questions.These patients have difficulty in evacuating the bowels, often irrespective of whether the stools are hard or loose.Some, on straining, feel as if a lump moved down and prevented the contents from being passed.Others state that the stools seem to collect at the side of, or in front of the anus and that pressure from without facilitates defaecation.I n many cases, haemorrhoids and anal fissures arise secondarily and aggravate the condition still further.The ordinary examination by palpation, proctoscopy and radiographic examination of the colon, brings out nothing to account for these symptoms in the majority of cases.This does not, of course, apply to tumours of the internal genital organs and rectum, which often cause similar symptoms.It is only when palpation through the rectum is carried out as the patient is straining that the characteristic signs may be detected (SNELLMAN).These signs, which may occur either separately or con-