US2457244A - Medical appliance for control of enemata - Google Patents

Description

.0. F, LAMSON MEDICALAPPLIANCE FOR CONTROL OF ENEMATA Dec. 28, 1948.

Filed June 22, 1943 IN VEN TOR.

Patented Dec. 28, 1948 MEDICAL APPLIANCE FOR CONTROL OF ENEMATA Otis F. Lamson, Seattle, Wash. Application June 22, 1943, Serial No. 491,841

1 Claim. 1

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 attendants 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 rectumin consequence obviating need for an attendants presence during the enemaand additionally serving the ofiice of a seal, precluding 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 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 relatively 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 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, 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 7 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: I

Figure l 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 toan enlarged scaleand being fragmentary to the extent that enema-fiow tubes leading to and from the appliance proper and an air-delivery catheter are broken away. In this view the balloon element which performs the holding and sealing oflice 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 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 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 denoted by the numeral 5 which is, or may be 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 '1. 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. 'rhegpip iigliteiihirially beaded "or dthe'rwise suitably formedaa-for example, "by the instrumentality of embedding male hose fittings in the two ends to accommodate the attachment, to the" rear end thereof, of a supply hesewfllifrom afluid container (not shown) and, to the forwarm'end, of a. clyster tip H forming the enema nozzle and having the usual vent or vents H'i' 1'? denotes an adapter embedded in theregposed; nipple 18, and attached thereto is a flexible catheter ld to which is connected an air syringe l4 having tl-ie usual one-way valve permitting atmospheric air to i -bec drawni fin'tot Cthenb'ulb 1 whilelztrappirig txthe sameagainstescape. B'I'here is iappli-eds-labout theopipezfii tol fiiitend in:i'oppositeidireotions beyondeithe EBLlIKJpGItIFQ- Ia f sl'ee've i=- td. be'zhereinafterutermedra balloonheld to the pipe by seizings iii-56 appliedzs'at "the :"Ilid Hextremities. .l Being sar-ranged .rto snorcmallyioccupy a'icollapsedilpositiomcsaidrballoonsis zinflatabl'etibyzithe ipressurerinfluence ofs airazina'ected ithrough the iduet"! zandmlliena so ainflated, assumesithe shape shown :by dotted 1 lines ziriz'Ei'g. -2Jandby1 run :linesxinFF-ig) 1. *i'lheiballoorrriss deisirablyiproducedizfrom aax'cylindei sofzfelastici rubberr butr 'teiss selfievidentzithatotlie s'anfe :admit's pfhthe'cusel ofzany'1flexible:.nonaporons:1material suchna-s rpaaachutersilk swhich,nperfnrceyawould fenrbodylthednecessary ifolds when collapsed'sto enableczthes same Ito: expandimnderiiniection (or pressure-air.

toccupyingzarposition tto ithef rarf-bf3th balloon and fitting if=reely2uporr the pipeist aepad t :1 indr- .catedzas wheingspf nspongei' rubber iandaabutting ctlie :oinierriace izthereofisise a disc '18. median; disc, composedzpfr'rubberimoreildense tin ltexture than ntha'tiof Itheapad; n'smrangeditorsnuglyoencompass lithe pipe and inztheiuse ofrthe applianee'irri'ction --ally;.grips:' the latter.

."Nowrreferringitormgsfl and 3pitswillrbeseen that substantially theo'nly izharige'ifromiithes con struction of Figs-4iiliesitin;rthetfactrofiiprdduning sthe ipineyas: 5',=with a-isu rfacerchannel zld corirel spondingwas. torlengthiyvithitheidubtr] and whinh is arrangedt-to lhavedthe roatheterui=3 .=-snileiy rfit rtherein with the: z18Itt81 S-1Outlet-: Bnd .leadingidimectl-y to ithe.=balloon,- a? *seizingn-Mbbeing applied .about :the :pifiErEXtQl-iOIlY 50f? the. friction :.disc-,-=i18 IOI'vWhiGh is -to -say: at a=point rearwardly memoyed items the; discatdaugment thehseizin-g. 4 Sin lfiliimg .the eatheterein position.

I z'Invlthesuse oi ither appliance ithernectahpipeawith its}; attached 3013 51181? tip, 1 and wi-th the nballo'on deflated, is inserted s' within; thepirectum :of l the patient to locateathehballooni fully raneinchaibewyondlthe: external splnnctervmuscle of: i-the anus, andhth-e attendantiihen:operates. ithesyringeato rinflatezthe balloomlsuchinflation occasioningf no discomfort to the :patient. The attendant then excus -tension upon the rectalzrpipe-zsinna withfdifaiwal :directioni toxpull' the fiexpanded-rballoon isnuglseagainsttherinternal 'sphincter'imusclerand fixes the appliance in this position by bringing :themad l "L: snugiyi againstc thel anus-i and :sli'din g Ithe .friction gdisc forwardly lto xhave'inthei same press nagainstthe mad, uithus 'zholding :lthe :ipad against shiftingaand causingsithe anal'rcanaleto be sealed by the stopper action of the balloon. The enema may be now given by attaching the supply hose ii! to the rectal pipe and suspending the enema can or bottle at a relatively low 5 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 with- "outideveloping bowel spasms.

"Iheappliance'maybe readily withdrawn for defecation by the instrumentality of removing the syringe from the catheter to allow escape of \ltherzpressure 'airi from the balloon. A valve for itliis purpose might of course be applied to ob- 5 viate the need for removing the syringe. Syringes are now produced to meet manifold require- "mentsandthere-is available, and commonly used, a bulb including a non-return checl:-accomplis hing the pumping function of the syringe- 20 and also equipped with a release valve to exhau'st the pumped airwhen it is desired to relieve" the pressure. 'Consequently, a syringe-oi this type,'. and which I prefer to employ-obviates notonly aneedfor removal-of the syringe when 5 it --is desi=redtaexhaust the pressure air in eifectuating a deflation of the balloon, but also obviates-thetneed for-anexhaust valve separate and apart from'l tlie syringe. It will beself-evident that-an exhausting-of the-air will causethe balloonito re-turn to the: deflated condition in which lit is shown in.- Fig.: 2 (fulllines) anddn Fig.4 and, rs'-o :deflated can be. passed freely through uthe anali canal tofclear the latter and permit th'e a'fpatient-to'voidfthe softened feces by natural d'cfecation.

:It should,s perhaps, be mentioned that in lieu --of'.:a; cushion rubberzpad no discomfort would be iattacheditotithe femployment of ra n inflexible :memberi dfh'ardrubber or plastidmolded to have in 'its frontali face, considered .in horizontal section,

ldescriberarr-Ielliptical:profile. There is thisracl- -vantagevvhichcwouldfollow from the used such :aaplecepbwcomparison with the cushion rubber palinnamelyithex-ease .incleaning andwhichzobiziaizeslthe-need, ordesirability, of applyinga sheet 'of?disposable'tissuerover the frontal faceofithe "rubber-pad.

10f epairticulariimportat the present time when rhospital's, tsespecia'lly as to nurses, are -shor-t- .ehanded; iitf'c'anvbe icons'er-vatively estimated that ithelnse ofriftheupresent appliance within a' 560- fbEdZhOSDitflI-Calfl save" upwards of 30 nursing hours a day. To the patient requiring eneniata, avhetheriindicatedras a' therapeutic treatment or 'r'esortedzto :fpruprophylactic reasons to preclude :thedev'elopment of conditions traced to constipathezzin'vention may-be said to introduoe an entirely newtechnique to' which the benefi-ts'hereiinbefore'ienumerated can be attributed.

I'It isrmy intention that no limitations beimplied as various change's beyond'those-herein spe- -dificallyreferred to will, without 'departing from 'rthefispirit of the invention, readily occur to those 'verseii in the 'airt.

What I' claim is Antapplianeefor' the controlof enema ta compri's'ing the'combination of a rectal pipe providing a main-fluid canal arranged to be inserted by its fOI W'ard-"end"through-the 'anal canal into" the lower regionee patien'ts bowel and being scammed-connect by-its rear end with anen ema t'ubees'aid pipe wheninsertedexposingits said rear end-beyond the distal endof said anal canal;'an

iiiflatableelement car riedupon' the forwarden d 7'5 'l'lf th e *pipeancnarrangeaand adapted td be baL looned 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 canal, said element being comprised of a single-thickness fistular-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 frointhe 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 patient and in consequence hold the inflated balloon against said internal mouth of the anal canal.

OTIS F. LAMSON.

5 REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS

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