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.

    28/30 (page 108)
    Pancreatic cysts are best treated by performing laparotomy, and either securing the cyst to the abdominal wall and draining, or by dissecting out the cyst. Simple aspiration has sometimes proved a successful method of cure. [/.] Hasmorrhagic. Here again blood may be found in the cavity of the lesser sac of the peritoneum, or in the substance of the great omentum itself. The causes of such extravasations are chiefly traumatism, haemorrhage into pancreatic cysts, from a rupture of one of the gastro-epiploic veins, especially in portal obstruction, and from acute and gangrenous pancreatitis. When the lesser sac is distended with blood, besides the symptoms of internal haemorrhage, a tumour can usually be palpated, or mapped out by percussion, which reaches down a little below the umbilicus, rather lower on the left than on the right side. If the normal cavity of the sac be distended with plaster of Paris or gelatine, it will be found that the stomach is pushed in front and compressed between the mass of injection and the anterior abdominal wall, while the transverse colon is pushed backwards against the spine. The position of the former may be determined by distending it with gas. M. Simon ^ records an interesting case of a man who died of cholera, in whose abdomen a cyst in the great omentum con- taining altered blood was found. This during life had given rise to the erroneous idea of a distended bladder. No cause for this extravasation could be discovered ; the gastro-epiploic vessels were apparently quite healthy. Old blood cysts may be dissected out, or removed with portions of omentum, or drained, Eecent haemorrhages are best left nndealt with surgically. [^.] Lastly, there are abscesses. These are most commonly the result of a perforating gastric or colic ulcer with subsequent localised peritonitis. A blood cyst may suppurate. The pus may be within the lesser sac, or between the omentum and the anterior abdominal wall. Incision and drainage is the only treatment, but the cases often end fatally. (ii.) Solid tumours of the omentum. These may be classified as innocent and malignant. The innocent growths include:— [a.] Lipoma. [&.] Fibroma, [c] Myxoma. Of these, lipoma is the commonest. It is only natural that 1 Bulletin de la Sooi^te Auatomique, 1858, p. 30.