ATRESIA ANI 131 



cases resulting from the failure of fusion of the 

 rectal and anal walls, the intervening tissue 

 should be carefully dissected and the walls of the 

 of the rectum and anus approximated and 

 sutured. When there has been a failure of cutan- 

 eous invagination a crucial incision should be 

 made through the skin and the intervening tissues 

 bluntly dissected to the lumen of the rectum, then 

 the mucous membrane of the rectum should be 

 pulled outward, sutured to the skin or margins of 

 the opening made by the dissection so that the 

 mucous membrane and skin are continuous and 

 form a lining for the artificial opening. 



If there is a communication between the intes- 

 tine and the bladder urethra, or vagina it should 

 be closed by a plastic operation and the external 

 opening made as indicated above. 



