Caring for affective subjects produced in intimate healthcare examinations

This article is about the feelings – affect – induced by the digital rectal exam of the prostate and the gynaecological bimanual pelvic exam, and the care doctors are or are not instructed to give. The exams are both invasive, intimate exams located at a part of the body often charged with norms and emotions related to gender and sexuality. By using the concept affective subject, we analyse how these examinations are taught to medical students, bringing attention to how bodies and affect are cared for as patients are observed and touched. Our findings show both the role care practices play in generating and handling affect in the students’ learning and the importance of the affect that the exam is (or is not) imagined to produce in the patient. Ours is a material-discursive analysis that includes the material affordances of the patient and doctor bodies in the affective work spaces observed.

CHRONIC CONSTIPATION IN INFANTS: THINK ABOUT RECTAL DUPLICATION

Rectum is the least common site of gastrointestinal duplication. Up to now fewer than 100 cases have been reported in the literature. We present two infants with cystic rectal duplications manifested with chronic constipation as a main clinical symptom. The first patient was a 4-year-old boy who was admitted to emergency department because of chronic constipation unresponsive to fiber supplements and laxatives. Digital rectal exam revealed mass adjacent to posterior rectal wall. Abdominal ultrasound and magnetic resonance imaging confirmed oval, homogenous and hypoechogenic cystic mass (87x65x60 mm in size) behind the rectum. The size and location of the cystic mass was confirmed by magnetic resonance imaging. The second patient was an 11-month-old boy who was hospitalized due to rectal bleeding. He was suffering from chronic constipation over the last five months. Digital rectal exam revealed a mass behind the rectum. Abdominal ultrasound and computed tomography showed unilocular cyst (33X33 mm in size) in front of the urinary bladder, partly extending into retrorectal space. Both patients were operated on. Postoperative periods were uneventful in both of them. Cystic rectal duplication must be ruled out in all infants with chronic constipation unresponsive to conservative treatment. Different imaging techniques are currently used to determine the precise size and location of duplication. Surgery is the only possible therapy option.