Some points in the minute anatomy of intussusception / by D'Arcy Power.

  • Power, D'Arcy, 1855-1941.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Some points in the minute anatomy of intussusception / by D'Arcy Power. 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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    the individual fibres have undergone but little if any change. The serous coat is separated from the muscular layer by many large venous channels, but for the most part it is healthy, and it only contains patches of extravasated blood at long intervals. The ileo-csecal valve has undergone changes in every respect similar to those described as occurring in the colon. The general structure is thickened and an extravasation of blood has taken place into its centre, whilst its lymphatics are blocked with leucocytes, showing how easily an inflammation might begin in the valve. The blood vessels, however, are not enlarged, and the epithelium lining its crypts of Lieberkiihn do not contain an undue proportion of goblet cells. The changes in the ileum are similar to those which have taken place in the large intestine. The villi, however, are reduced to mere tags of connective tissue. The submucous layer is thickened by an extensive extravasation of blood, which has not yet undergone any change. The circular layer of muscle is comparatively healthy, though blood has been effused into its substance, but the longitudinal layer of muscle is completely disorganised. Its fibres are widely separated from each other by the effused corpuscles, and the protoplasm of the muscle cells is becoming degenerate. The serous coat is also greatly thickened by the effused blood. The next section (Plate XXXVII. Fig. 4) is taken from an intus- susception, which was made experimentally in a cat by drawing the colon over the cascum and the lower part of the ileum, and securing it with a few point sutures at the neck of the invagination. The specimen was obtained by resecting the invaginated intestine a week afterwards. The animal made an excellent recovery and is still alive. The minute anatomical changes are again more marked in the mucous and submucous layers than in the muscular and serous coats, but this specimen differs from the previous one in the fact that the mucous membrane has suffered more severely than the submucous tissue. The villi covering the mucous membrane are much congested (Plate XXXVII. Fig. 5), and the blood corpuscles are escaping from them in many parts into the lumen of the intestine. The diapedesis of white corpuscles is only just beginning, and as there has not been any great multiplication of cells, it may be assumed that the inflammatory process has • hardly advanced beyond the stage of congestion and stasis. The apices of many of the villi are often curiously invaginated, a change which is due, in all probability, to unequal shrinkage during the hardening process, though I do not remember to have seen it in any of the numerous sections I have examined when teaching classes of normal histology. The columnar epithelium of the villi is con- verted almost wholly into goblet cells. The crypts of Lieberkiihn are quite healthy, their epithelium is normal, and they are not
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