Cases of hernia of the bladder met with during operations for inguinal and femoral hernia / by Christian Fenger.

  • Christian Fenger
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Cases of hernia of the bladder met with during operations for inguinal and femoral hernia / by Christian Fenger. 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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    this account many of the writers on this subject during the last five or six years have paid especial attention to and have de- scribed very carefully all the essential characteristics of hernia of the bladder. One of the chief points in vesical hernias is the relation of the hernial sac to the bladder, which again is identical with the relation of the peritoneum to the protruding part of the organ. This has been clearly yet briefly described by Dieflen- bach in 1848, as follows : “ Hernias of the bladder have some- times a hernial sac, at other times none. If that part of the bladder which has a peritoneal covering prolapses, there is a hernial sac. If a part of the bladder uncovered by peritoneum protrudes, the sac is wanting. If a portion of the bladder on the border line between the intra- and extra-peritoneal surface comes out, then there is half a hernial sac.” (That is, a hernial sac is present on half the prolapsed surface of the bladder, and on the other half the sac is absent.) The location of the hernia is invariably in the medial and lower part of the respective rings, inguinal as well as femoral; if an intestinal hernia is also present its contents are situated above and to the external side of the vesical hernia. I. We most frequently find the peritoneum of the sac cover- ing only a portion of the prolapsed bladder, its upper anterior surface is clad with peritoneum, but the inferior medial portion is not. The sac, whether empty or filled, is ordinarily larger than the prolapsed portion of the bladder; it extends further out or lower down, so that the bladder is found as a small mass at the neck of the sac only, on its inferior medial aspect. II. Less frequently a complete sac is found; that is, the pro- truding bladder is entirely covered by peritoneum, as in my case of inguinal hernia. Case I. Synopsis. Left fe^noral her?iia ; 7io distinct symptoms of heniia of the bladder; radical operation ; bladder not recog- nized and opejied; bladder wound sutured ajid anchored to deep portion of wound ; recovery without leakage.—-Miss L. S., school- teacher, aged twenty-three years, was admitted to the German
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