Observations on the diseases of the rectum ... / by T.B. Curling.

  • Curling, T. B (Thomas Blizard)
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the diseases of the rectum ... / by T.B. Curling. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    249/292 (page 229)
    reached. In two instances I was una])le to find the colon. Both the subjects were well-formed iiifants, still-born at the full term, one male, the other female. On opening the bodies I observed that the descending colon before reaching the pelvis made rather a sharp curve, and, passing across the abdomen in front of the fourth lumbar vertebra, formed an ample convo- lution on the right side before terminating in the rectum. Colotomy in the left groin was consequently impossible, in both these cases, owing to the unusual course taken by the descending colon ; but the bowel was easily opened in the right groin. This disposi- tion of the colon has been observed in a case of im- perforate anus, one already referred to, where death resulted from rupture of the terminal sac. Mr. Lys, who communicated the particulars of the case to me, states, that the descending colon, instead of being directed to the left iliac fossa to form the- sigmoid flexure, passed transversely across the spine over the fourth lumbar vertebra to the right sacro-iliac sym- physis, and, descending into the pelvis, terminated in a cul-de-sac at the base of the bladder. In eight of the twenty subjects the colon was readily found, and opened in the loin without wound- ing the peritoneum. In six the operation was more or less difficult, owing, in two, to the great depth of the gut, in two to its being empty and contracted as weir as deeply seated, and in two to a large kidney being in the way and concealing the bowel. Had the subjects been living, I apprehend that the diffi- culties of the operation would have been increased. In six subjects, lumbar colotomy was impossible without opening the peritoneum, in consequence of the colon being attached by a distinct mesentery