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.

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    A similar cord-like structure may be formed in cancerous disease of the omentum, but is said to be much more common in tuberculosis. Gairdner has called especial attention to this swelling. In children it generally undergoes gradual resolution. A resonant percussion-note may sometimes be elicited above the mass. Though usually situated in the umbilical region, the omental mass may form a prominent tumour in either iliac region. (c.) Tumours of the great omentum may be either cystic or solid. (i.) Cystic tumours of the omentum. [a.] Serotis.—This is generally the outcome of peritonitis, leading either to a collection of fluid in the lesser cavity of the peritoneum or encysted by adhesions.^ I have seen one such case, where the signs closely resembled those of an ovarian cystoma.^ Other cases are instances of lymphangiectasis of the great omentum.^ Eemoval of the fluid by aspiration after laparotomy may effect a cure, or, if feasible, the cyst itself may be removed, with or without portions of the omentum. [&.] Hydatid.—Usually multiple, and perhaps studded over the peritoneum. Enucleation cures some cases. [c] Chylous.—The outcome of dilated lymphatics or chyle channels. [d.] Dermoid.—These may arise in two ways, either, as Mr. W. G. Spencer has suggested, from coelomic tissue, or they may be merely ovarian dermoids to which the omentum had become adherent, and subsequent separation from the primary seat of their origin has resulted. This is the opinion of Mr. Knowsley Thornton, Mr. Bland Sutton, Mr. Alban Doran, and others. Their obvious treatment is removal. [e.] Pancreatic.—It is not my intention to enter deeply into the highly interesting subject of pancreatic cysts, but merely to refer to such points concerning them as have a special connec- tion with the great omentum and the lesser peritoneal sac. In passing, however, it may be said that there are three probable origins of such cysts:— [i.] Injury. The pancreas, although situated quite at the 1 See a specimen in Museum, R.C.S., No. 1109. where a small cyst may be seen between the two layers forming the anterior part of the omentum. 2 See also a case of Dr. Bantock's recorded in Obstet. Soc. Trans., 1881, p. 164.