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.

    29/30 (page 109)
    a tumour comiDosed of adipose tissue should at times occur in the omentum. Earely it grows to a very large size, and simulates to a certain degree an ovarian tumour. Dr. Meredith ^ records a case where he removed one weighing- fifteen and a half pounds. The malignant growths are :— [a.] Carcinoma. [i.] Endothelioma. [ii.] Scirrhous. [iii.] Colloid. [&.] Sarcoma. Generally spindle-celled. Any of these malignant growths, except the so-called endo- thelioma, may be primary or secondary, but probably the majority are of a secondary origin. Endothelioma springs from the endothelial cells of the peri- toneum, and is therefore primary. It resembles the primary carcinoma of the lungs. Colloid carcinoma, or the degeneration of a colloid form of the cells of other carcinomata, is a very interesting disease. The clinical features of a case are a gradual and great enlarge- ment of the abdomen, more marked in certain parts than in others. The umbilicus is seldom everted, though it may be much stretched. On palpation firm irregular masses may be felt over the region of the omentum. Fluctuation, even if there be fluid present, is dijEcult to obtain, and always indistinct. On percussion over the front of the abdomen, a large area will be found to be dull, and change of the position of the patient produces no alteration of its extent. If an aspirator be employed, only some small quantity of a slimy gelatinous fluid will be withdrawn. The omentum will be found to be very greatly thickened by the deposit. Any radical treatment of such cases is of course out of the question. In conclusion, a curious condition which is found in the omentum may be alluded to—I refer to what has been termed fat necrosis —on account of its having a bearing on surgery. There are now several cases on record in which, because of symptoms resembling those of intestinal obstruction, the abdomen has been opened, and this peculiar condition of fat necrosis has been discovered. 1 British Medical Journal, 1887, vol. i. p. 936.