Intestinal obstruction; its varieties : with their pathology, diagnosis, and treatment.
- Sir Frederick Treves, 1st Baronet
- Date:
- 1899
Licence: Public Domain Mark
Credit: Intestinal obstruction; its varieties : with their pathology, diagnosis, and treatment. 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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![of the epiploon lias become adherent, the attached portion separates as a cord, which becomes in time dense and librous. If the omentum has formed extensive adhesions, its whole substance may be changed into a series of cords passing between the transverse colon and various other parts of the abdominal cavit}^ Such was the condition of things, for example, in a case of Dr. Fagge's, the many false liga- ments that had formed being attached to the abdominal parietes and small intestines in many places.^ In any case the omentum from which a band is derived is often found much altered in structure, having become thin and reticulate. One of the most curious modes of forming omental bands is met with in a case described by Dr. K. FoAvler. f Here the epiploon was divided into two lateral cords, which, coming off from either side of the transverse colon, passed down behind or amonsf the intestines, and were found to be united together near the pelvis. All the patient's troubles dated from a kick received upon the abdomen. It is probable that in this case a rent had formed in the omentum, through which the great bulk of the small intestines had protruded. The lateral parts of the omentum, i.e. the parts on both sides of the rent, had then shrunken into cord-like masses, which would be more or less hidden by the bowels. Dr. Hilton Fagge has put upon record an almost similar case in his monograph in the Guj-'s Hospital Reports. When once a portion of the epiploon has become adherent the development of the attached part into a ligamentous cord is to be explained by the same process that fashions a broad ribbon-like adhesion into a hbrous thread. The segment of the adherent omentum is continuall} being dragged upon, especially when attached to a movable viscus: it tends to become elongated, while the rolling movements of the bowels around it help to mould it into a rounded cord- like ligament. {See page 29.) As a rule, the omental cords are much coarser and thicker than are the bands resulting from peritoneal adhesions. Many are nearly as thick as the finge]', while only a few are described as being very fine. In the matter of length they usually have an advantage over the simple band, as may be expected from the dimensions and relations of the great omentum. The jDoint of attachment of the epiploic band will obviously depend upon the situation of the peritonitis, Avhich renders it adherent. Such adhesion may follow after * C4uv's Hosp. Eeports, loc. cit. t Path. Soc. Trans., 1882, p. 146.](https://iiif.wellcomecollection.org/image/b21205516_0056.jp2/full/800%2C/0/default.jpg)
