The practice of surgery / by James Gregory Mumford ... with 682 illustrations.

  • James Gregory Mumford
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: The practice of surgery / by James Gregory Mumford ... with 682 illustrations. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    by its tip to the navel; or it may be a nicro blind pouch, similar to the appendix. Generally, it sj)rings from the ileum, from 15 to 30 inches above the ileocecal valve, but it ma}- arise from any part of the intestine, and usually from the side opposite the mesenteric attachment. When you operate for supposed appendicitis and find the appendix normal, search for a Meckel's diverticulum. Its blood- and nerve-supply are those of the intestines, as its musculature is from the intestines. Sometimes, through persistent granulation at the navel, there is external evidence of a chverticulum; and, when ])atulous throughout, it may form the sac of an umbilical hernia. This brief sketch of the anatomy shows that a IMeckel's diverticulum may cause trouble in two ways—by becoming diseased itself, like the Fig. 21.—Meckel's diverticulum (Warren Museum, Harvard, Specimen No. 7915). appendix, or by obstructing, entangling, and strangulating the gut in some fashion. Inflammation, or diverticulitis, as it has been called, has occurred in about 13 per cent, of the reported cases of diseased diverticula,^ and among these are a few from typhoid and tuberculous ulcers. Far more commonly it acts by strangulating the bowel as by a band—59 per cent.; while there are many cases of intussusception, or telescoping of the diverticulum (10 per cent.), of hernia (10 per cent.), and several cases of volvulus or twist about the diverticuhim. It appears that when the diverticulum forms a mere cord from gut to navel, strangulation of the intestine is probabl}- never produced. 1 Miles F. Porter, Jour. Amer. Med. Assoc, September 23, 1905, discusses 184 reported cases in a valable paper, Abdominal Crises Caused by Meckel's Divertic- ulum.