Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment / by Frederick Treves.

Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Intestinal obstruction : its varieties with their pathology, diagnosis, and treatment / by Frederick Treves. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    63/542 page 49
    the Guy's Hospital Museum* shows an intussuscep- cion in the immediate vicinity of such a pouch, and from the condition of the parts there is every reason to believe that the diverticulum was antecedent to the obstruction. The connection, however, between the two might have been purely accidental. These pouches, and especially those of the colon, are apt to lodge little fascal masses and foreign matters of various kinds. Inflammation of the pouch may be induced by such lodgment, and peritonitis fi-om perforation result, just as occurs in the appendix vermiformis. Notice has already been drawn to the fact that the colic diverticula are apt to project into appendices epiploicEe; and it is quite probable that in those cases where such an appendix has caused an isolated adhesion a pouch might have formed in the appendage, have lodged a foreign substance of some kind, and have been, in consequence, the seat of a limited peritonitis. Thus, Mr. Hulke records a case where an epiploic appendage was adherent to the pelvic perito- neum near the right sciatic notch. Beneath the arcade so formed a loop of bowel had been strangu- lated. The appendix was on the sigmoid flexure, which extended in an angular loop across the pelvis.f In a specimen in the College of Surgeons Museum it will be seen that an appendix has become adherent to the omentum in such a way as to cause stenosis of the part of the colon from which it arose; In this case the comparatively large size of the involved appendix is conspicuous. J I have found two cases on record where a false diverticulum in the sigmoid flexure communicated with the interior of the bladder by an ulcerated open- ing. Here also it is probable that inflammation was * Guy's Hosp. Museum, No. 1,849 (10). t Medical Times and Gazette, vol. ii., 1872, page 482. + Oo]l. of Surgeons Museum, No. 1,362. E—12
    digitised image 1
    digitised image 2
    digitised image 3