The great omentum : notes on its development, anatomy, physiology, and pathology / by W. McAdam Eccles.

  • Eccles, William McAdam, 1867-1946.
Date:
[1895?]
Catalogue details

Licence: Public Domain Mark

Credit: The great omentum : notes on its development, anatomy, physiology, and pathology / by W. McAdam Eccles. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    20/30 (page 100)
    More recently Mr. Macreadyi upholds the view of Mr. Holmes, although he mentions opposing statements: A piece of omentum may be strangulated and accompanied by symp- toms which cannot be distinguished from those of constricted intestine. It is generally admitted that the symptoms to which strangulated omentum gives rise are usually of less severity than when bowel is included—the vomiting is less frequent, and less copious, and the bowels may act unless peritonitis comes on. Again, Mr. W. H. Bennett ^ says: It is a notorious clinical fact that strangulation of herniated omentum is generally associated with constipation of the most obstinate kind, and frequently with all the other symptoms of strangulation. He gives the notes ^ of a very interesting case, however, in which there were no symptoms of strangulation besides pain, and no true hernial impulse; and yet when he performed hernio- tomy, the sac was found to contain a large mass of omentum, congested throughout, at the back of which was a small area of commencing gangrene. Lastly, I will quote on this side of the question Gosselin, who says: Tout ^ coup la tumeur devient plus volumineuse; si elle ^tait r^ductible, elle ne se reduit plus; elle devient chaude, douloureuse k la pression et pendant les mouvements. En m^me temps apparaissient quelques coliques; parfois, mais pas toujours, des naus^es et quelques vomissements, dans un certain nombre de cas meme la constipation. I now turn to the statements of Mr. Eushton Parker,* who is opposed to the view that nipping of omentum per se leads to symptoms of strangulation. Strangulated omentum, he says, can have no symptoms, and that in cases where signs of strangulation are present a loop of bowel has been strangulated, or some other cause of obstruction is present. M. Paul Berger,^ in commenting on the statement of Gosselin given above, writes: Telles sont la physionomie et la marche de ces accidents, et c'est un des principaux m^rites de Mal- gaigne d'avoir prouv^ et proclaim^ tres haut qu'ils recon- naissaient pour course I'inflammation de la hernie et de I'epiploon qu'elle renferme, la peritonite hernaire et I'epiploite, et qu'ils n'avient rien de commun avec I'etranglement, dont la condition formelle est la presence de I'intestin dans la hernie. 1 Macready, A Treatise on Ruptures, p. 349- 2 Bennett, Lectures on Abdominal Hernia, p. 12. ^ Op. cit., p. 2. , T . „ , •• * Parker, Abdominal Hernia, p. 17- See also Lancet, 1876, vol. 11. p. 219.