Title:
Medical appliance for control of enemata
United States Patent 2457244


Abstract:
This invention relates to a device for giving enemata, and for its general object aims to provide an appliance operative to preclude premature expulsion of the introduced fluid and thereby enable an attendant to positively control rectal injections. Clarity in an understanding of this and...



Inventors:
Lamson, Otis F.
Application Number:
US49184143A
Publication Date:
12/28/1948
Filing Date:
06/22/1943
Assignee:
Lamson, Otis F.
Primary Class:
Other Classes:
600/29, 604/42, 604/918
International Classes:
A61F2/00; A61F2/958
View Patent Images:
US Patent References:
1245325N/A1917-11-06
0835496N/A1906-11-13
0616963N/A1899-01-03
0577775N/A1897-02-23
0565386N/A1896-08-04
0397060N/A1889-01-29



Foreign References:
FR439636A1912-06-19
FR742746A1933-03-14
Description:

This invention relates to a device for giving enemata, and for its general object aims to provide an appliance operative to preclude premature expulsion of the introduced fluid and thereby enable an attendant to positively control rectal injections.

Clarity in an understanding of this and other more particular objects and advantages in view will perhaps be advanced by here stating that enemata, as heretofore given, have required constant attention on the part of a nurse or other attendant. As a result thereof and particularly where the demands upon an attendant's time are relatively heavy-this condition being especially pronounced at the present time when hospitals are forced to operate with far less than the usual number of help-there is a not unnatural tendency to give enemata with undue haste. Aside from the pain to the patient caused by resulting bowel spasms, some patients, and this is especially evidenced in cases of a weak sphincter muscle of the anus, are entirely unable to retain the injected fluid, in consequence expelling the same prematurely. Bed linen unnecessarily soiled in this manner is one item which reflects itself in the exceptionally heavy laundering requirements of hospitals. Moreover, it becomes self-evident that an expulsion of enema fluid before the same has served its intended end of entirely loosening and softening congested feces within the bowel requires repetitive clyster operations which, if resorted to at too frequent intervals, can be quite harmful to the patient.

Having the foregoing in mind, the present invention aims to devise an enema control appliance providing a clyster tip in association with means functioning to fixedly hold the same within the rectum-in consequence obviating need for an attendant's presence during the enema-and additionally serving the office of a seal, preclud- 4 ing premature escape of the injected fluid. The device is, therefore, one which enables an attendant to insert the appliance, set the same for any desired degree of slow-feed flow, and then go about his or her other duties, giving other 4 enemata if called for, during the relatively protracted time period required to best consummate a softening of the stool. It will be thus apparent that the appliance operates to largely overcome spasms of the bowel and permit fluid, slowly injected, to reach the upper limits of the colon.

During the course of the enema, the ordinary convalescent patient can, of course, make slight adjustments in the fluid flow and can take the enema in comparative comfort with the bowel rel- 56 atively relaxed as distinguished from the usual rigidity which sympathetically follows when, as heretofore, it becomes necessary to exert a certain amount of effort in maintaining a contracted condition of the external sphincter muscle of the anus.

The present invention provides a highly satisfactory method of giving nutrient enemata, also retention enemata which are indicated in some 1( instances and are performed by clamping the fluid-supply tube at a point distal from the appliance or, otherwise stated, at a point intermediate the appliance and the container for the fluid.

In the field of retention enemata are, of course, '5 barium injections which are resorted to for X-ray purposes and which, previous to the present invention, have occasioned considerable annoyance to the medical fraternity due to premature expulsion of the liquid-suspended barium.

The invention serves the further and important end of providing an assured method of giving enemata to patients with a colostomy, namely, an artificial anus; the procedure consists in the new method of fixedly holding an enema tube 2' or, more properly, the rectal part thereof, within the rectum while coincidently sealing the anal canal against leakage, and in the novel construction, adaptation and combination of parts hereinafter described and claimed.

In the accompanying drawing: Figure 1 is a perspective view portraying the invention and showing the same applied to a patient preparatory to giving an enema.

Fig. 2 is a detail longitudinal vertical section of one embodiment with the view taken to an enlarged scale and being fragmentary to the extent that enema-flow tubes leading to and from the appliance proper and an air-delivery catheter are broken away. In this view the balloon elero ment which performs the holding and sealing office of the invention is shown in its inactive normal condition by full lines and in its active inflated condition by dotted lines.

Fig. 3 is a transverse vertical section taken to 5 an enlarged scale on line 3-3 of Fig. 2; and Fig. 4 is a view similar to Fig. 2, excepting that I have shown a somewhat modified construction in which the air duct which supplies pressure air for inflating the balloon is molded 0 into the enema-flow pipe as an integral part thereof.

First describing the invention as illustrated in Fig. 4 and which constitutes the now preferred embodiment, there is provided a rectal pipe de5 noted by the numeral 5 which is, or may be 2,457,244 3 molded from, rubber or one of the various applicable plastics to provide a main canal 6 open at the two ends and, along one side, present a longitudinal air duct 7. This duct connects toward the rear end of the pipe with a laterally projecting nipple 8 and extends forwardly to a point somewhat short of the forward limit of the pipe whereat the same terminates in a surface outlet 9. Thepipe As: tterminally be6ded 'or idtherwise suitablyr formed as, for example, by the instru- 10 mentality of embedding male hose fittings in the two ends to accommodate the attachment, to the rear end thereof, of a supply hose 40 -fromva fluid container (not shown) and, to the forward-end, of a clyster tip ! I forming the enema nozzle and having the usual vent or vents I ': 12 dn: tes an adapter embedded in thet-exposed; nipple 8, and attached thereto is a flexible catheter 13 to which is connected an air syringe 14 havin-g he usual one-way valve permitting atmospheric air 20 .to;:,bet drawn,:lirito:;the';bulb, while-, trappirigi..the -same against escape.

_.There iislapplied:.abott theopipei.5,toe -in.-opposite: directions ;beyondithe airoport39 ra 'sleeve 15-to. be;;hereinafter: termedi- a ballodnheld to the pipe by seizings 16-16' applied-;at -the -enid extremities. .1 Being:- arranged rto tnor-anallyoccupy a:tcollappsed;p6sition,;;saidaballoonsis inflatable bydthe 6pressure influence ofaairnin:jbctedithrough- the duct'-i andp~whlreso-inflated, -assumes--the shape shown:by dottedilines:ri.*igg. --2and'byi.ftll:lines in?'F-igJ-l. -Theiballoonmisde.sirably_;produced-:fromia: ;cylindelsofi-elastic: rub.ber:4butc:it:Ais; self-evident:ithatthe-e samee admits vofi-the:use bfs any, flexible--non-poronus: -sichnasapa-dhuite-'silk -which,:-pedrfrce,'-ouid r-embody-thednecessary afolds when ..collapsed:oto -enable thee same -to. expand-.under.injection tlf pressure.ir.

,.Occupyingra:positiontithe rear:bi ~h balloon .andfittingifreely.upor the pipe isaeapad d ;t:intli.ttedsas ~reing."Df espDngen .rubber,laid..:abutting -the-ou-er.:faee:thereof;-is-aidisce--8. -8-:Schidisc, -lcompiose±.b.frrubbentimre- densetin itexture than A:that7ofIthepadd;-is-arrangedtto.-snugly-encompass "the piie and :intheiuse.:oftthe applianceifrictiunally grips: the -latter.

-,Noow:-referring.ito~-Fgs.-2 and 3pit;will-be.seen that substantially the-ouly change froT.mthe: onstruction of Fig.4 iliesilnthe fact:-of)iprdduning ,the pipe-as 5', with a:-siurface-channel :1'9s--cdre-spondiingias todlength.with'the-dutt .T and-which is arranged,-to have;the -catheter :I3.asnugly.-.it hthereinwth -the-tltter's-,outleti:end leadigIdi-rectly. to the.;balloon; a-seizing,,-20,being applied .about the ,pipe-exteriorly :ofF the friction -disc' 48 ,orwhich isato say at..appoint -rearwardly removed drom the, discito.augment the.seizing -1 ~iin fixing -he eatheter.,in position.

:In- theuse of itherappliance therectalpipe.iwith g60 -its.; attached. clyster tip, -and-,with. hebballoon .deflated, is inserted ,within- the.irgctum patient to locateA.the-,balloon fully.-ann.inch Tbe-yond the.-.external :Sphinctermuscle. of ithe -anus. andthe atterndant:-then.-operates. the :syrige, -to "65 Tinflatethe balloon,.such inflation occasioning- no -discomfort to the rpatient. The attendant then -exerts- tension upon the rectal tpipe; in-:a 'withIditwal !direction; to :pulll the expanded -balloon =snuglyagainst.the internal sphincter mustle,,and fixes the appliance in this position by bringing :the -pad- I 1 - nugly- against-.the anus-larid-sliding ;the :'fdriction :disc- forwardly >to :have -the: same -press tagainst the :pad, thus -.holding Athe :,pad against shiftingrarid daausingthe nalmt:canalato 4 be sealed by the "stopper" action of the balloon.

The enema may be now given by attaching the supply hose 10 to the rectal pipe and suspending the enema can or bottle at a relatively low elevation of, say, 12 to 16 inches, assuring a slow injection of the fluid and thereby permitting the latter to work gradually through the entire colon and effectively loosen and soften the feces without.devieloping bowel spasms.

:The appliance may be readily withdrawn for defecation by the instrumentality of removing -the syringe from the catheter to allow escape of ithe,.pressure-air- from the balloon. A valve for '-this purpose might of course be applied to obviate the need for removing the syringe. Syringes are-now produced to meet manifold require-ments. and there is available, and commonly used, a bulb including a non-return check-accompishing-the pumping function of the syringeand also equipped with a release valre to exIihdult the -pumped air when it isidesired ito re-lieve;the -pressure. Consequently, a syringe of -tend this type,.and which I prefer to employ, obviates notonily a- need .for removal of -the syringe when dit -isdesired to-exhaUst the pressure air in effectuating a deflation of the balloon, but also obvigtes.)the need for.an exhaust valve separate and .apart.:from';the syringe. It will be self-evident that.an exhausting of the air will cause-the balloon to return to the deflated condition in which it is shown in: Fig.::2 (full lines) and in Fig.4 anld,:d.o deflated,: can be passed freely through theanal:.canal to clear:the latter and permit -the :patient to void:the s6ftened:feces by natural defematerial 35 cation.

-:It should, perhaps, be mentioned that in lieu ..of- a cushion 'rubber pad no discomfort would be rattached .to ithe -employment of an inflexible :nember:i.f hard rubber or rlastic molded to have . .its frontal-face, oconsidered in horizontal section, describe anelliptical profile. There is thisdvantage-whitchwould follow from the use of such :a:piece,,by-,comparison with the cushion rubber pad;in-amely.-the.ease in.cleaning and which ob.iatesithe need, or-desirability, of applying a sheet -f -fdispbsable-tissue-:over the frontal face of the -rubber pad.

:Of pArticulariimport at the present time; when Thospitals, .especially as to nurses, are :short50o handed. ,itbcan'be ,conservatively estimated that 'the--use 'of. the; present appliance within. a ,500-bedihoSpital can save upwards of 30 nursing-hours a day. To the patient requiring eriemita, -.whdtherindicated as a therapeutic treatment or -resortedýto for .prophylactic reasons to preclude :the'development of conditions traced to constipa-tion, the:invention may be said to introduce an -entirely new technique to-which the benefits here. inbefore senumerated can be attributed. ;It fis nmy intention: that no limitations be' im·plied as various-changes beyond those-herein speof, the -difically referred Lto will, without'departing from the-spiritiof the invention, readily occur to those 'versedlin the:art.

.What 'I claim lis: ':An-.appliance'for the control of enemata cornpriSirig the combination-of a rectal pipe providing a.main.'fluid .canal arranged to be inserted by its -forward-- end -through the anal canal :into the '70 -lower region -of -a patient's bowel and being Adaptddd to;connect by-its rear end with an enema t;tubeisAld-pipe when'inserted exposing its said-rear iid"b0yonid the-distal end of said anal canal;'an i-iflatabtle"elemenrit carried upont the forward end "'5 iof;the'pipea-rid!arrsanged and adapted td be ballooned by injection of pressure air from a normally collapsed condition permitting the same to pass freely through said anal canal into an expanded compass exceeding that of the internal mouth of the anal eanal, said element being comprised of a single-thickness flstular-shaped sheet of elastic rubber sleeved over said forward end of the pipe and, when collapsed, finding a snug fit upon the latter and having its end extremities made fast to the pipe to provide a seal against the escape of air introduced to the element for ballooning the same; an air duct isolated from said main fluid canal of the pipe and extending longitudinally from the outer end of the pipe to terminate in an outlet port giving access to the interior of the balloon, the admission end of said air duct being arranged for connection with a source of controlled pressure air; and means also carried upon the pipe and in the use of the appliance operating to fit snugly against the anus of the o0 patient and in consequence hold the inflated balloon against said internal mouth of the anal canal.

OTIS F. LAMSON.

REFERENCES CITED The following references are of record in the file of this patent: UNITED STATES PATENTS Number 397,060 565,386 577,775 616,963 835,496 1,245,325 Number 439,636 742,746 Name Date Knapp -------- Jan. 29, 1889 Meengs --------- Aug. 4, 1896 Mussey -------- Feb. 23, 1897 Pearl ------------- Jan. 3, 1899 Brandon ------- Nov. 13, 1906 Dunn - --------Nov. 6, 1917 FOREIGN PATENTS Country Date France ----------- June 19, 1912 France ---------- Sept. 12, 1932